P3277 - Outcomes of Esophageal Stent Placement in Patients With Cardio-Pulmonary Disease – A National Inpatient Sample Study (NIS)

Herman Suga, DO¹, Jason John, DO², Chun-Wei Pan, MD³, Kirti Dasu, BA⁴, Neethi Dasu, DO⁵, Yaser Khalid, DO⁶, C. Jonathan Foster, DO⁷, Richard Walters, DO^8
1Jefferson Health, Philadelphia, PA; ²Jefferson Health, Stratford, NJ; ³John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ⁴Drexel University, Cherry Hill, NJ; ⁵Jefferson Health, New Jersey, NJ; ⁶Wright Center for GME/Geisinger Health System, Scranton, PA; ⁷Jefferson Health, Cherry Hill, NJ; ⁸Jefferson Health, Voorhees Township, NJ

Introduction: Esophageal stents are widely used in clinical practice for the treatment of a wide variety of esophageal diseases, including malignancies, perforations, fistulas, and strictures. Stents have also been used for palliation of esophageal obstruction or dysphagia. The purpose of this study was to identify risk factors that lead to worsened outcomes in patients undergoing esophageal stent placement in a national population cohort in the USA.

Methods: We conducted a retrospective analysis of the NIS database for the years 2015-2019. Patients with a principal diagnosis of esophageal stent placement and a secondary diagnosis of cardiac or pulmonary disease [coronary artery disease (CAD), non-ST-elevation myocardial infarction (NSTEMI), obesity, asthma, hypertension (HTN), diabetes mellitus (DM) and lung cancer] were identified using ICD-10 codes. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay (LOS), and hospital charges (TOTHC) after adjusting for demographic characteristics.


Results: Our study identified approximately 2,225 patients undergoing esophageal stent placement. Of these patients, 225 patients died (1.01%). We then identified co-morbidities that led to worsened in-hospital outcomes in this patient population.
On multivariate analysis, in patients undergoing esophageal stent placement, a positive predictor of increased mortality was the presence of CAD (OR: 2.16, p< 0.04, 95% CI: 1.37 - 3.65), HTN (OR: 1.60, p< 0.054, 95% CI: 1.36 - 3.22), or lung cancer (OR: 5.03, p< 0.025, 95% CI: 1.32 - 9.55).
LOS was increased if patients had any of the following co-morbidities: HTN (+2.20 days, p< 0.044, 95% CI: 1.41 - 3.81) or asthma (25.2, p< 0.0001, 95% CI: 13.73 - 36.80).
TOTHC were increased in patients who had NSTEMI ($186,639.60, p< 0.004, 95% CI: $60,638.29 - $312,640.80), obesity ($187,286.30, p< 0.001, 95% CI: $86,622.55 - $287,950.10) or asthma ($320,879.30, p< 0.0001, 95% CI: $154,591.00 - $487,167.60).

Discussion: Our study shows that patients undergoing esophageal stent placement had higher mortality with CAD and lung cancer, increased LOS with HTN and asthma, and finally increased TOTHC with NSTEMI, obesity, or asthma. The placement of esophageal stents is a useful endoscopic treatment option for patients. However, there are minimal studies that evaluate risk factors that worsen hospital outcomes in patients undergoing esophageal stent placement.


Disclosures:


Herman Suga, DO¹, Jason John, DO², Chun-Wei Pan, MD³, Kirti Dasu, BA⁴, Neethi Dasu, DO⁵, Yaser Khalid, DO⁶, C. Jonathan Foster, DO⁷, Richard Walters, DO⁸. P3277 - Outcomes of Esophageal Stent Placement in Patients With Cardio-Pulmonary Disease – A National Inpatient Sample Study (NIS), ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.