Trends in the timing of inpatient ERCP relative to cholecystectomy: a nationwide database studied longitudinally Alejandro L. Suarez, MD, Huiping Xu,

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Presentation transcript:

Trends in the timing of inpatient ERCP relative to cholecystectomy: a nationwide database studied longitudinally Alejandro L. Suarez, MD, Huiping Xu, PhD, Peter B. Cotton, MD, B. Joseph Elmunzer, MD, MS, David Adams, MD, Katherine A. Morgan, MD, Douglas Sheafor, MD, Gregory A. Coté, MD, MS Gastrointestinal Endoscopy Volume 88, Issue 3, Pages 502-510.e4 (September 2018) DOI: 10.1016/j.gie.2018.04.2354 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Study flow diagram. Gastrointestinal Endoscopy 2018 88, 502-510.e4DOI: (10.1016/j.gie.2018.04.2354) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Changes in inpatient ERCP utilization. The overall use of inpatient ERCP increased over time, with a 1.7% (95% CI, 1.4%-2%) increase in the odds for ERCP use year over year (P < .001). Therapeutic ERCP increased most dramatically (4.8%; 95% CI, 4.5%-5.2%) year over year and was partially offset by a decrease in purely diagnostic ERCP during the same period (8.9%; 95% CI, 8.4%-9.4%; P < .001 for each comparison). CI, Confidence interval. Gastrointestinal Endoscopy 2018 88, 502-510.e4DOI: (10.1016/j.gie.2018.04.2354) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 (A) Temporal trends in timing of ERCP and cholecystectomy and (B) association with length of stay. Length of stay shows a significant decreasing trend, after adjusting for covariates (P < .001), irrespective of the timing between ERCP and CCY. After adjusting for patient, facility, and procedure covariates (eg, presence of acute pancreatitis or cholangitis, performance of open CCY, and presence of 1 or more postoperative adverse events, among others), ERCP performed within 1 day of CCY was associated with a significantly shorter length of stay (P < .001). CCY, Cholecystectomy. Gastrointestinal Endoscopy 2018 88, 502-510.e4DOI: (10.1016/j.gie.2018.04.2354) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions