P2887 - Outcomes of Endoscopic Drainage of Pancreatic Pseudocysts in Patients With COVID-19: Sepsis Is a Poor Prognostic Marker

Herman Suga, DO¹, Jason John, DO², Chun-Wei Pan, MD³, Kirti Dasu, BA⁴, Neethi Dasu, DO⁵, Yaser Khalid, DO⁶, C. Jonathan Foster, DO^7
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

Introduction: COVID-19 is a novel virus that has impacted the medical community in unprecedented ways, especially in terms of how to prepare and proceed for endoscopic procedures. Gastrointestinal procedures and their outcomes have not been well studied in patients with COVID-19, especially for those undergoing endoscopic drainage of pancreatic pseudocysts. COVID-19 will most likely remain a global threat for many years to come, so its impact on endoscopic procedures will need to be analyzed. The objective of our study was to identify risk factors that impact hospital outcomes of patients with COVID-19 undergoing endoscopic drainage of pancreatic pseudocysts.

Methods: The NIS is a large publicly available all-payer inpatient care database in the USA and was queried. We conducted a retrospective analysis of the Nationwide Inpatient Sample (NIS) database for the year 2020. Patients with a principal diagnosis of endoscopic drainage of pancreatic pseudocyst with and without COVID-19 were identified using the ICD-10 codes. Multivariate regression analysis was used to calculate the odds ratios of in-hospital mortality, the average length of hospital stay (LOS), and hospital charges (TOTHC) using STATA 17 MP.



Results: Our study identified approximately 1,685,745 patients with COVID-19, of which 750 patients underwent endoscopic drainage of a pancreatic pseudocyst.
On multivariate analysis, in patients undergoing endoscopic drainage of a pancreatic pseudocyst, a positive predictor of increased mortality was sepsis (OR: 9.95, p< 0.0001, 95% CI: 2.95 - 16.95).
LOS was increased if patients had any of the following complications: sepsis (+18.92 days, p< 0.0001, 95% CI: 12.04 - 25.81), AKI (+6.90 days, p< 0.0001, 95% CI: 3.92 - 9.89), aspiration (+23.35 days, p< 0.0029, 95% CI:2.42 - 44.28), or congestive heart failure (CHF) (+11.73 days, p< 0.016, CI 2.20 - 21.26).
TOTHC was increased in patients who had sepsis ($247,426, p< 0.0001, 95% CI: $163,441-$331,411), acute kidney injury (AKI) ($43,083, p< 0.034, 95% CI: $3,297-$82,870) or CHF ($126,086, p< 0.009, 95% CI: $31,041- $221,131).


Discussion: Based on our study, those with COVID-19 undergoing endoscopic drainage of pancreatic pseudocysts had increased mortality if the patients had a complication of sepsis. Positive predictors of LOS and TOTHG were the following: sepsis, AKI, and CHF. Our study is novel as the first NIS study evaluating hospital outcomes in this patient population.


Disclosures:


Herman Suga, DO¹, Jason John, DO², Chun-Wei Pan, MD³, Kirti Dasu, BA⁴, Neethi Dasu, DO⁵, Yaser Khalid, DO⁶, C. Jonathan Foster, DO⁷. P2887 - Outcomes of Endoscopic Drainage of Pancreatic Pseudocysts in Patients With COVID-19: Sepsis Is a Poor Prognostic Marker, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.