S972 Malnutrition Is Associated With Worse Outcomes of Endoscopic Retrograde Cholangiopancreatography: A Nationwide Analysis

Introduction: Malnutrition is commonly found among hospitalized patients, and it is generally known to be associated with poor clinical outcomes. However, there is a lack of studies on how malnutrition affects the outcomes of endoscopic retrograde cholangiopancreatography (ERCP). Thus, this study aims to assess the outcomes of ERCP among patients with malnutrition. Methods: Adult patients hospitalized with a procedure diagnosis of ERCP from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality 2014 were selected. Diagnoses were identified by using ICD-9 CM codes. Patient demographics and outcomes of ERCP were compared between the groups with and without malnutrition. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, and ERCP complications including pancreatitis, cholecystitis, cholangitis, sepsis, hemorrhage, and intestinal perforation. Chi-squared tests and independent t-tests were used to compare proportions and means, respectively. Multivariate logistic regression analysis was performed to determine if malnutrition is an independent predictor for the outcomes, adjusting for age, sex, race, and the Charlson Comorbidity Index. Results: Among 5,664 patients with a procedure diagnosis of ERCP identified, 746 patients had a history of malnutrition. Patients with malnutrition had longer length of stay (15.5 days vs. 6.7 days, p < 0.05) and higher hospital charge ($149,699 vs. $71,723, p < 0.05). After adjusting for age, sex, race, and the Charlson Comorbidity Index, malnutrition was an independent risk factor for inpatient mortality (aOR 2.54, 95% CI: 1.70-3.82, p < 0.05), sepsis (aOR 2.20, 95% CI: 1.82-2.65, p < 0.05), hemorrhage (aOR 1.64, 95% CI: 1.05-2.56, p < 0.05), and intestinal perforation (aOR 4.29, 95% CI: 1.61-11.46, p < 0.05). Adjusted odds ratios of other outcomes were not statistically significant. Conclusion: Our study indicates that patients with malnutrition are more likely to have worse outcomes, such as increased inpatient mortality and higher risks of sepsis, hemorrhage, and intestinal perforation. Understanding the nutrition status of patients undergoing ERCP can be a useful approach for risk stratification and determining if closer surveillance of the complications is warranted.