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Burdens Of Postoperative Infection In Endoscopic Retrograde Cholangiopancreatography Inpatients

Shanthini Kuduva Rajan, Sowmya Madireddy, Paul Rahul Jaladi, Virendrasinh Ravat, Anum Masroor, Uwandu Queeneth, W. Rashid, R. Patel
Published 2019 · Medicine

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Objectives Our objective in this study is, firstly, to determine postoperative (POI) rates in endoscopic retrograde cholangiopancreatography (ERCP) procedures stratified by patients’ demographic and hospitals’ characteristics in the United States, and secondly, to evaluate the demographic and comorbid risk factors associated with POI in ERCP inpatients, as well as its impact on the length of stay (LOS) and total charges. Methods The total sample of 28,525 inpatients with a principal procedure of ERCP from the Nationwide Inpatient Sample (NIS) was included and grouped by co-diagnosis of POI (N=300, 1.05%). We used a logistic regression model and descriptive statistics for the POI rate estimates. Results High POI rate was seen in males (1.14%), and adults (36-50 years, 1.25%) with 2.65 times (95% CI 1.69-4.12) higher odds compared to young adults. POI rate in ERCP inpatients varied widely according to geographic region: higher in the West (1.46%) and Northeast (1.20%) and lowest in the Midwest (0.70%). As per the hospital characteristics, inpatients in public (1.26%), urban teaching (1.39%) and small bed-size (1.27%) hospitals had higher POI rates. ERCP inpatients with POI had higher odds of association with comorbid HIV infection (OR 1.55, 95% CI 1.13-2.12) and diabetes (OR 1.43, 95% CI 1.09-1.85). ERCP inpatients with POI had a significantly longer length of stay (LOS) by 5.2 days and higher total charges by USD 53,966 than inpatients without POI. Conclusions POI is associated with acute inpatient care, with longer hospitalization stays and higher costs, leading to increased healthcare burdens. The main goal is to identify the risk factors and to prevent POI with prophylactic antibiotics.
This paper references
10.1007/s00268-018-4733-4
Associations of Hospital Length of Stay with Surgical Site Infections
Edin Mujagic (2018)
10.1016/S0016-5107(02)70365-9
Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis.
R. Rerknimitr (2002)
Post-ERCP acute pancreatitis and its risk factors
A. Iorgulescu (2013)
10.1055/s-0042-101407
Prospective evaluation of bacteremia rates and infectious complications among patients undergoing single-operator choledochoscopy during ERCP.
N. Thosani (2016)
10.1016/S0016-5107(92)70474-X
Bacteremia following diagnostic and therapeutic ERCP.
E. Kullman (1992)
10.1067/S0016-5107(03)01883-2
Guidelines for antibiotic prophylaxis for GI endoscopy.
W. Hirota (2003)
10.1186/s12876-017-0570-4
Prophylaxis of post-ERC infectious complications in patients with biliary obstruction by adding antimicrobial agents into ERC contrast media- a single center retrospective study
H. Wobser (2017)
Guidelines of the European Society of Gastrointestinal Endoscopy (E.S.G.E.) antibiotic prophylaxis for gastrointestinal endoscopy. European Society of Gastrointestinal Endoscopy.
J. R. Rey (1998)
10.1016/S1499-3872(17)60056-0
Prospective comparison of prophylactic antibiotic use between intravenous moxifloxacin and ceftriaxone for high-risk patients with post-ERCP cholangitis.
N. Kim (2017)
Complications of endoscopic retrograde cholangiopancreatography: how to avoid and manage them.
N. Szary (2013)
NIS description of data elements
10.17235/reed.2017.4771/2016
Cholangitis after endoscopic retrograde cholangiopancreatography: a rare complication?
A. Peixoto (2017)
E.) antibiotic prophylaxis for gastrointestinal endoscopy
J R Rey (1998)
): e5237. and meta-analysis. Endosc Int Open
Kuduva Rajan (2019)
10.1186/s13756-017-0290-0
Post-ERCP infection and its epidemiological and clinical characteristics in a large Chinese tertiary hospital: a 4-year surveillance study
Mingmei Du (2017)
10.1177/0033354916679807
Infectious Disease Hospitalizations Among American Indian/Alaska Native and Non–American Indian/Alaska Native Persons in Alaska, 2010-2011
P. Gounder (2017)
10.1055/s-2008-1077722
ESGE-ESGENA Guideline: cleaning and disinfection in gastrointestinal endoscopy.
U. Beilenhoff (2008)
10.1111/j.1572-0241.2007.01279.x
Incidence Rates of Post-ERCP Complications: A Systematic Survey of Prospective Studies
A. Andriulli (2007)
10.4103/2230-8210.94253
Infections in patients with diabetes mellitus: A review of pathogenesis
J. Casqueiro (2012)
10.1055/S-2007-1004085
Antibiotic prophylaxis in gastrointestinal endoscopy: a report by a Working Party for the British Society of Gastroenterology Endoscopy Committee.
V. Mani (1997)
10.1007/S11894-003-0084-9
Understanding risk factors and avoiding complications with endoscopic retrograde cholangiopancreatography
M. Freeman (2003)
10.1016/j.gie.2011.07.010
Complications of ERCP.
Michelle A. Anderson (2012)



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