P2886 - Identification of Risk Factors That Worsen Outcomes in Patients With Pancreatic Cancer Undergoing Endoscopic Retrograde Cholangiopancreatography

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: Pancreatic cancer is a leading care of morbidity and mortality in the United States. Therapeutic interventions, such as ERCP, play a crucial role in the management of advanced pancreatic cancers. Malignant biliary obstructions from pancreatic cancer have become a common indication for ERCP with balloon dilation or stenting of pancreatic and biliary strictures often being performed. The aim of this study was to identify post-procedural risk factors that lead to worsened in-hospital outcomes of patients with pancreatic cancer undergoing ERCP.

Methods: We identified patients (18 years and older) with and without pancreatic cancer undergoing ERCP from the National Inpatient Sample (NIS) utilizing ICD 10 codes. The NIS, which is a large publicly available all-payer inpatient care database in the USA, was queried from the years 2015-2019. 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: We identified 1,088,175 patients undergoing ERCP of which 80,225 patients had pancreatic cancer. There was increased mortality (OR:2.29; p< 0.0001; 95% CI: 1.83 - 2.86) and increased LOS (+ 0.69 days; p< 0.0001; 95% CI: 0.45- 0.94). Post-processional complications which led to worsened outcomes were identified (Table 1). Complications of aspiration, post-procedural bleeding, cholangitis, and duodenal and esophageal perforation led to increased mortality in patients with pancreatic cancer undergoing ERCP. The presence of pancreatitis, aspiration pneumonia, post-procedural bleeding, gastric perforation, cholangitis, and duodenal perforation led to increased LOS and TOTHC (Table 1).


Discussion: Our study highlighted post-procedural risk factors that worsen in-hospital outcomes in patients with pancreatic cancer undergoing ERCP. This is an important study because identifying post-procedural risk factors can help physicians mitigate adverse outcomes, diminish costs, and reduce the healthcare burden 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. P2886 - Identification of Risk Factors That Worsen Outcomes in Patients With Pancreatic Cancer Undergoing Endoscopic Retrograde Cholangiopancreatography, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.