P3460 - Burden of Cocaine Use and Associated Racial Differences in Patients with Non-Variceal Upper GI Bleed

Raissa Nana Sede Mbakop, MD¹, Kikelomo Olaosebikan, MD¹, Arnold Forlemu, MD, MPH², Tayla Greene, MD¹, Vishnu Poojitha Ronda, MD², Praneeth Bandaru, MD², Saigopal R. Gujjula, ³, Srilaxmi Gujjula, MD², Vijay Gayam, MD², Pavani Reddy Garlapati, MD², Hamsika Moparty, MD², Madhavi Reddy, MD², Denzil Etienne, MD^2
1Piedmont Athens Regional Medical Center, Athens, GA; ²Brooklyn Hospital Center, Brooklyn, NY; ³American University of Antigua, Coolidge, Saint John, Antigua and Barbuda

Introduction: Gastrointestinal (GI) hemorrhage is the most common GI discharge diagnosis in the United States (US) noted by a nationwide review of data. The impact of these hospitalizations poses a great burden on the US health care system, with a direct cost estimated at $5 billion in 2018. With the increasing use of illicit drugs in the last decade, we aim to explore the prevalence of these conditions among cocaine users and any existing associated racial patterns.



Methods: A nationwide study was conducted using the 2009 to 2014 nationwide inpatient sample database (NIS) for this study. NIS is the largest publicly available all‐payer inpatient database in the US that >7 million hospital stays each year, as a part of the Healthcare Cost and Utilization Project (HCUP). International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for cocaine use and non-variceal upper GI bleed (NVUGIB) were obtained. Likewise, information on age, sex, race/ethnicity, insurance type and geographic region, hospital type were also obtained. Chi square tests were used to compare proportions and student t tests were used to compare means of continuous variables. Statistical significance was set at p< 0.05.

Results: We found 1,073,174 patients with NVUGIB, of whom 9,342 were cocaine users. Cocaine users were more likely to die from such NVUGIB than non-users, 9.6% vs 7.7%, (odds ratio 1.40 95% CI 1.37 -1.43, p< 0.01). Hispanic cocaine users had more NVUGIBs vs non-Hispanics (2.8% vs 2.6%, p< 0.01, Also, Native American cocaine users had a higher percentage of NVUGIB (3.4% vs 3.1%) and were more likely to die from it than non-natives (20.3% vs 9.3% p< 0.05). White cocaine users had fewer non variceal bleeding episodes than other races, 1.9% vs 2.9% (odds ratio 0.72, 95% CI 0.62 – 0.85, p< 0.01). Medicare cocaine users had fewer NVUGIB (2.2% vs 3.8%), but a higher in-hospital mortality, 9.5% vs 7.4%, p=0.012. LOS and total charges were significantly higher in cocaine users with NVUGIB compared to non-cocaine users, p< 0.01

Discussion: Cocaine use was associated with increased in-hospital mortality in NVUGIB. Interestingly, this trend was noted to be higher among the Hispanic and Native Americans. The use of illicit/recreational drugs in the US remains on the rise, and further relaxations being implemented in drug laws can substantially increase their burden on the healthcare system with minority groups being the most likely to be impacted.


Disclosures:


Raissa Nana Sede Mbakop, MD¹, Kikelomo Olaosebikan, MD¹, Arnold Forlemu, MD, MPH², Tayla Greene, MD¹, Vishnu Poojitha Ronda, MD², Praneeth Bandaru, MD², Saigopal R. Gujjula, ³, Srilaxmi Gujjula, MD², Vijay Gayam, MD², Pavani Reddy Garlapati, MD², Hamsika Moparty, MD², Madhavi Reddy, MD², Denzil Etienne, MD². P3460 - Burden of Cocaine Use and Associated Racial Differences in Patients with Non-Variceal Upper GI Bleed, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.