E3343. In-Hospital Outcomes of Gastroduodenal vs. Left Gastric Arterial Embolization for Bleeding Peptic Ulcer Disease
Authors
Hwan Lee;
Perelman School of Medicine at the University of Pennsylvania
Paul Hong;
Loyola University Medical Center
Yifeng Yang;
University of Iowa Hospitals & Clinics
Objective:
Gastrointestinal bleeding secondary to peptic ulcer disease (PUD) can be successfully treated with transcatheter arterial embolization (TAE). The two main targets for TAE are the gastroduodenal artery (GDA) and left gastric artery (LGA) depending on the location of the ulcer. We examined whether there is any difference in in-hospital outcomes between the patients who receive TAE of GDA vs. LGA for bleeding PUD.
Materials and Methods:
Using the International Classification of Diseases 10 Clinical Modification and Procedure Coding System, we queried the National Inpatient Database to identify a sample of adult patients admitted for bleeding PUD and treated with TAE of GDA or LGA in the United States in 2016 - 2019. The procedure codes for the “hepatic” and “gastric” arteries including their branches were used to define the GDA and LGA groups respectively. The in-hospital outcomes and resource requirements were compared between the two groups with multivariate regression, accounting for comorbidities including iron deficiency anemia and coagulopathy.
Results:
The study included 1,724 patients in the GDA group and 1,563 patients in the LGA group. The median age was 68 years, and 39% of the patients were women. Between the two groups, there was no significant difference in the demographics including ethnicity and insurance status. Overall in-hospital mortality was 12.6%, without significant difference between the GDA and LGA groups (12.8% vs. 12.4%, <em>P</em> = 0.96). There was no significant difference in the rates of pressor requirement (<em>P</em> = 0.11), intubation (<em>P</em> = 0.18), parenteral nutrition (<em>P</em> = 0.54), surgical intervention (<em>P</em> = 0.87), or nonhome discharge (<em>P</em> = 0.29). Between the GDA vs. LGA groups, the total cost of hospitalization ($78,807 vs. $75,130, <em>P</em> = 0.26) and the duration of stay (13.6 days vs. 13.3 days, <em>P</em> = 0.23) did not show any significant difference.
Conclusion:
Patients treated with TAE of GDA vs. LGA for bleeding PUD show similar in-hospital outcomes and resource requirements, supporting their equivalency as treatment approaches for bleeding PUD.
