P2044 - The Early Bird Gets the Scope: A Nationwide Study of Early Colonoscopy in Lower GI Bleeding Outcomes and Health Care Utilization

Mohammad A. Ahmed-Khan, MD¹, Mahnoor Hanif, MD², Nkechi Okam, MD³, Zakee Jiffry, MD³, Kayvon Moin, BS^4
1Danbury Hospital - Yale School of Medicine, Danbury, CT; ²CMH Lahore Medical College, Lahore, Punjab, Pakistan; ³Danbury Hospital, Danbury, CT; ⁴AUC School of Medicine, Danbury, CT

Introduction: Gastrointestinal bleeding leads to significant morbidity and mortality in the United States every year. In hospitalized individuals who presented for admission with lower gastrointestinal bleeding has a mortality rate of between 10 to 20%. The current standard of care includes appropriate resuscitation, supportive measures, and Lower GI Endoscopy. Therapeutic and diagnostic colonoscopy is the gold standard for lower GI bleeding (LGIB).

Methods: LGIB was identified using International Classification of Disease 10th Revision codes from the National Inpatient Sample database for 2016 to 2019 in hospitalized adults from 2016 to 2019 using the National Inpatient Sample (NIS). Adult patients (Age >18) with a diagnosis of LGIB were stratified into 2 categories early (EC) and late (LC) colonoscopy. The population and their outcomes were then analyzed using logistic and multivariate regressions; this data was also adjusted for weighting which is part of the innate characteristics of the NIS database.

Results: 1,549,065 adults were diagnosed with LGIB based on our characteristics, these adults were then stratified by those who received colonoscopy and those who did not while in the inpatient setting. 285,165 were identified as having colonoscopy during that inpatient admission; this subset of patients was then stratified into EC and LC. 107,045 patient's were in the EC group and 178,120 patients were in the LC group. Patients who received EC had a decreased inpatient mortality as compared to LC (0.9% EC vs 1.4% LC, p < 0.001). EC patient's also had a decreased length of stay (LOS) than LC (3 days vs 5 days, p < 0.001). Hospital charges were also different between EC and LC (32,037 vs 44,092, p < 0.001) showing EC added decreased hospital utilization cost.

Discussion: Early colonoscopy had a decreased rate of inpatient mortality and hospitalized adults in the NIS database with lower GI bleed, as well as decreased median length of stay and total charges. This data was statistically significant and showed that early colonoscopy and inpatient hospitalized adults to decrease length of stay, charges and mortality. This study is important because as colonoscopy does remain the gold standard inpatients receiving early colonoscopy versus late colonoscopy as a procedure during that hospitalization does have an effect on comparative cost and a minor benefit in mortality but needs to be explored further with possible cohort studies of patients that received these 2 treatment protocols.


Disclosures:


Mohammad A. Ahmed-Khan, MD¹, Mahnoor Hanif, MD², Nkechi Okam, MD³, Zakee Jiffry, MD³, Kayvon Moin, BS⁴. P2044 - The Early Bird Gets the Scope: A Nationwide Study of Early Colonoscopy in Lower GI Bleeding Outcomes and Health Care Utilization, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.