Unplanned Hospital Encounters After Endoscopic Retrograde Cholangiopancreatography in 3 Large North American States

Gastroenterology
Robert J HuangSubhas Banerjee

Abstract

We have few population-level data on the performance of endoscopic retrograde cholangiopancreatography (ERCP) in the United States. We investigated the numbers of unplanned hospital encounters (UHEs), patient and facility factors associated with UHEs, and variation in quality and outcomes in the performance of ERCP in 3 large American states. We collected data on 68,642 ERCPs, performed at 635 facilities in California, Florida, and New York from 2009 through 2014. The primary endpoint was number of UHEs with an ERCP-related event within 7 days of ERCP; secondary endpoints included number of UHEs within 30 days and mortality within 30 days. Each facility was assigned a risk-standardized cohort, and variations in number of UHEs were analyzed with multivariable analysis. Among all ERCPs, 5.8% resulted in a UHE within 7 days and 10.2% within 30 days. Performance of sphincterotomy was significantly associated with a higher risk of UHE at 7 and 30 days (P < .001). Younger age, female sex, and more advanced comorbidity were associated with UHE. There was substantial heterogeneity in rates of UHE among facilities: 4.2% at facilities in the 5th percentile and 25.2% at facilities in the 95th percentile. Increasing facility volume and abi...Continue Reading

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Citations

Feb 14, 2020·Digestive Diseases and Sciences·Monique T BarakatSubhas Banerjee
Oct 3, 2020·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Ji Young BangShyam Varadarajulu
Oct 14, 2020·British Journal of Anaesthesia·Friederike C AlthoffMatthias Eikermann
Jan 22, 2021·Gastrointestinal Endoscopy·Robert J HuangSubhas Banerjee

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