PMID- 30416316
OWN - NLM
STAT- MEDLINE
DCOM- 20190111
LR  - 20190111
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 24
IP  - 41
DP  - 2018 Nov 7
TI  - End-stage renal disease is associated with increased post endoscopic retrograde 
      cholangiopancreatography adverse events in hospitalized patients.
PG  - 4691-4697
LID - 10.3748/wjg.v24.i41.4691 [doi]
AB  - AIM: To determine if end-stage renal disease (ESRD) is a risk factor for post 
      endoscopic retrograde cholangiopancreatography (ERCP) adverse events (AEs). 
      METHODS: We performed a retrospective cohort study using the Nationwide Inpatient 
      Sample (NIS) 2011-2013. We identified adult patients who underwent ERCP using the 
      International Classification of Diseases 9(th) Revision (ICD-9-CM). Included 
      patients were divided into three groups: ESRD, chronic kidney disease (CKD), and 
      control. The primary outcome was post-ERCP AEs including pancreatitis, bleeding, 
      and perforation determined based on specific ICD-9-CM codes. Secondary outcomes 
      were length of hospital stay, in-hospital mortality, and admission cost. AEs and 
      mortality were compared using multivariate logistic regression analysis. RESULTS: 
      There were 492175 discharges that underwent ERCP during the 3 years. The ESRD and 
      CKD groups contained 7347 and 39403 hospitalizations respectively, whereas the 
      control group had 445424 hospitalizations. Post-ERCP pancreatitis (PEP) was 
      significantly higher in the ESRD group (8.3%) compared to the control group 
      (4.6%) with adjusted odd ratio (aOR) = 1.7 (95%CI: 1.4-2.1, (a) P < 0.001). ESRD 
      was associated with significantly higher ERCP-related bleeding (5.1%) compared to 
      the control group 1.5% (aOR = 1.86, 95%CI: 1.4-2.4, (a) P < 0.001). ESRD had 
      increased hospital mortality 7.1% vs 1.15% in the control OR = 6.6 (95%CI: 
      5.3-8.2, (a) P < 0.001), longer hospital stay with adjusted mean difference (aMD) 
      = 5.9 d (95%CI: 5.0-6.7 d, (a) P < 0.001) and higher hospitalization charges aMD 
      = $+82064 (95%CI: $68221-$95906, (a) P < 0.001). CONCLUSION: ESRD is a risk 
      factor for post-ERCP AEs and is associated with higher hospital mortality. 
      Careful selection and close monitoring is warranted to improve outcomes.
FAU - Sawas, Tarek
AU  - Sawas T
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Bazerbachi, Fateh
AU  - Bazerbachi F
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Haffar, Samir
AU  - Haffar S
AD  - Department of Gastroenterology, Digestive Center for Diagnosis and Treatment, 
      Damascus 00000, Syrian Arab Republic.
FAU - Cho, Won K
AU  - Cho WK
AD  - Division of Gastroenterology and Hepatology, Georgetown University Medstar 
      Washington Hospital Center, Washington, DC 20010, United States.
FAU - Levy, Michael J
AU  - Levy MJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Martin, John A
AU  - Martin JA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Petersen, Bret T
AU  - Petersen BT
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Topazian, Mark D
AU  - Topazian MD
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Chandrasekhara, Vinay
AU  - Chandrasekhara V
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, 
      United States. abudayyeh.barham@mayo.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
SB  - IM
MH  - Aged
MH  - Cholangiopancreatography, Endoscopic Retrograde/*adverse effects
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Kidney Failure, Chronic/*complications
MH  - Length of Stay/economics/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Pancreatitis/*epidemiology/etiology
MH  - Postoperative Hemorrhage/*epidemiology/etiology
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC6224476
OTO - NOTNLM
OT  - End-stage renal disease
OT  - Endoscopic retrograde cholangiopancreatography
OT  - Nationwide Inpatient Sample
COIS- Conflict-of-interest statement: Authors have nothing relevant to this study to 
      disclose.
EDAT- 2018/11/13 06:00
MHDA- 2019/01/12 06:00
PMCR- 2018/11/07
CRDT- 2018/11/13 06:00
PHST- 2018/08/08 00:00 [received]
PHST- 2018/10/04 00:00 [revised]
PHST- 2018/10/16 00:00 [accepted]
PHST- 2018/11/13 06:00 [entrez]
PHST- 2018/11/13 06:00 [pubmed]
PHST- 2019/01/12 06:00 [medline]
PHST- 2018/11/07 00:00 [pmc-release]
AID - 10.3748/wjg.v24.i41.4691 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2018 Nov 7;24(41):4691-4697. doi: 
      10.3748/wjg.v24.i41.4691.