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Clinical outcomes of nonvariceal upper gastrointestinal bleeding in nonagenarians and octogenarians: a comparative nationwide analysis
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Khaled Elfert, James Love, Esraa Elromisy, Fouad Jaber, Suresh Nayudu, Sammy Ho, Michel Kahaleh
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Clin Endosc 2024;57(3):342-349. Published online February 7, 2024
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DOI: https://doi.org/10.5946/ce.2023.130
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 Graphical Abstract
 Abstract
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 - Background
/Aims: Nonagenarians will purportedly account for 10% of the United States population by 2050. However, no studies have assessed the outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) in this age group.
Methods
The National Inpatient Sample database between 2016 and 2020 was used to compare the clinical outcomes of NVUGIB in nonagenarians and octogenarians and evaluate predictors of mortality and the use of esophagogastroduodenoscopy (EGD).
Results
Nonagenarians had higher in-hospital mortality than that of octogenarians (4% vs. 3%, p<0.001). EGD utilization (30% vs. 48%, p<0.001) and blood transfusion (27% vs. 40%, p<0.001) was significantly lower in nonagenarians. Multivariate logistic regression analysis revealed that nonagenarians with NVUGIB had higher odds of mortality (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3–1.7) and lower odds of EGD utilization (OR, 0.86; 95% CI, 0.83–0.89) than those of octogenarians.
Conclusions
Nonagenarians admitted with NVUGIB have a higher mortality risk than that of octogenarians. EGD is used significantly in managing NVUGIB among nonagenarians; however, its utilization is comparatively lower than in octogenarians. More studies are needed to assess predictors of poor outcomes and the indications of EGD in this growing population.
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Increasing trend of endoscopic drainage utilization for the management of pancreatic pseudocyst: insights from a nationwide database
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Khaled Elfert, Salomon Chamay, Lamin Dos Santos, Mouhand Mohamed, Azizullah Beran, Fouad Jaber, Hazem Abosheaishaa, Suresh Nayudu, Sammy Ho
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Clin Endosc 2024;57(1):105-111. Published online August 4, 2023
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DOI: https://doi.org/10.5946/ce.2023.054
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Graphical Abstract
Abstract
PDFPubReaderePub
 - Background
/Aims: The pancreatic pseudocyst (PP) is a type of fluid collection that typically develops as a delayed complication of acute pancreatitis. Drainage is indicated for symptomatic patients and/or associated complications, such as infection and bleeding. Drainage modalities include percutaneous, endoscopic, laparoscopic, and open drainage. This study aimed to assess trends in the utilization of different drainage modalities for treating PP from 2016 to 2020. The trends in mortality, mean length of hospital stay, and mean hospitalization costs were also assessed.
Methods
The National Inpatient Sample database was used to obtain data. The variables were generated using International Classification of Diseases-10 diagnostic and procedural codes.
Results
Endoscopic drainage was the most commonly used drainage modality in 2018–2020, with an increasing trend over time (385 procedures in 2018 to 515 in 2020; p=0.003). This is associated with a decrease in the use of other drainage modalities. A decrease in the hospitalization cost for PP requiring drainage was also noted (29,318 United States dollar [USD] in 2016 to 18,087 USD in 2020, p<0.001).
Conclusions
Endoscopic drainage is becoming the most commonly used modality for the treatment of PP in hospitals located in the US. This new trend is associated with decreasing hospitalization costs.
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Citations
Citations to this article as recorded by  - Pancreatic pseudocyst: The past, the present, and the future
Jonathan GA Koo, Matthias Yi Quan Liau, Igor A Kryvoruchko, Tamer AAM Habeeb, Christopher Chia, Vishal G Shelat
World Journal of Gastrointestinal Surgery.2024; 16(7): 1986. CrossRef
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