Factors influencing admission and outcomes in gastroparesis.
BACKGROUND
Current data suggest that gastroparesis is associated with an increased mortality, with reported rates ranging from 4% to nearly 40%. Considering this variability, the goal of this study was to determine mortality rates and risk factors for adverse outcomes in gastroparesis.


METHODS
Using the diagnosis code for gastroparesis, admission rates, duration of hospitalizations, discharge status, and inpatient mortality were determined for emergency department encounters and admissions compiled in the Nationwide Emergency Department Sample and Nationwide Inpatient Sample of the Agency for Healthcare Research and Quality. Comorbid conditions, procedural evaluations, age cohort, and gender distribution were examined as potential risk factors.


RESULTS
More than 50% of the emergency encounters for gastroparesis resulted in admission with age, cardiovascular, renal, and infectious disorders, but not diabetes mellitus being associated with higher admission rates. Inpatient mortality was 1.2 ± 0.1%, was not negatively affected by diabetes mellitus as comorbidity, and increased with coexisting infections and with more aggressive therapy. Discharge status was similarly affected by comorbidities, treatment complications, and more aggressive therapy.


CONCLUSIONS
These results demonstrate that gastroparesis does not come with a high mortality risk, with most deaths being due to comorbid conditions. Although gastrostomies and/or nutritional support were used in only a minority of admissions, the associated increase in morbidity and mortality highlights the need to carefully select the right candidates for such interventions and to discuss the common occurrence of adverse outcomes with patients.
Division of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. bielefeldtk@upmc.edu
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D018589:Gastroparesis / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult