P4193 - The Hidden Burden of Non-Diabetic Gastroparesis: A Population-Based Study of Hospitalization Outcomes

Anjul Verma, MD¹, Avneet Kaur, MBBS², Guy Loic Nguefang Tchoukeu, MD¹, Sameer Rao, MBBS³, Edgar Luna Landa, MD¹, Hayden Mathews, BS⁴, Lauren Glover, ⁴, Megan Mobley, ⁴, Sachi Khemka, MBA, BS⁵, Virginia McGrath, BS⁴, Vanya Rai, MBBS⁶, Merry Mathew, BS⁴, John Garza, PhD⁷
1Texas Tech University Health Sciences Center, Odessa, TX; 2SUNY Upstate Medical University, Syracuse, NY; 3Rutgers New Jersey Medical School, Newark, NJ; 4Texas Tech University Health Sciences Center School of Medicine, Odessa, TX; 5Texas Tech University Health Sciences Center, Amarillo, TX; 6Mayo Clinic, Rochester, MN; 7Texas Tech University Health Sciences Center - Permian Basin, Odessa, TX

Introduction: Gastroparesis is a debilitating gastrointestinal motility disorder often associated with diabetes and its complications, including diabetic polyneuropathy (DPN). While DPN is a recognized risk factor for gastroparesis, limited data exist comparing the clinical profiles, healthcare utilization, and procedural patterns of gastroparesis hospitalizations with versus without coexisting DPN.

Methods: We conducted a population-based cohort study using deidentified data from acute care hospitalizations in Texas (Q1 2016–Q2 2024) to examine outcomes in adults with gastroparesis (ICD-10-CM: K 31.84). The primary exposure was diabetic neuropathy identified using ICD-10-CM codes E0843, E0943, E1043, E1143, and E1343. Hospitalizations were included if gastroparesis was the principal diagnosis or listed secondary to diabetic neuropathy. Primary outcomes were length of stay and inflation-adjusted total charges. Overlap propensity score weighting was used, with results reported as adjusted risk ratios and 95% confidence intervals (aRR [95% CI]).

Results: Of 33,103 gastroparesis-related hospitalizations, 81.8% had coexisting diabetic polyneuropathy (DPN). Compared to those with DPN, patients without DPN were more often White (55.7% vs. 31.7%), female (67.5% vs. 58.1%), with higher rates of mental health disorders (45.0% vs. 34.2%), malnutrition, and rheumatologic conditions (all p < 0.0001). In contrast, DPN patients were more likely to be middle-aged, and had a higher burden of comorbidities, including heart failure (15.4% vs. 6.8%), renal disease (39.0% vs. 11.9%), and diabetes-related complications (99.9% vs. 3.0%). In the propensity score–matched cohort, non-DPN patients had longer stays (4.96 vs. 4.03 days; aRR 1.23) and higher charges ($65,677 vs. $56,859; aRR 1.16), with greater use of diagnostic endoscopy, particularly EGD with biopsy. Despite higher comorbidity in DPN patients, resource use was greater in the non-DPN group.

Discussion: In this large, nationally representative cohort, gastroparesis hospitalizations with DPN were characterized by greater comorbidity burden, whereas those without DPN demonstrated higher diagnostic and procedural intensity, longer hospital stays, and increased costs. These findings suggest a divergence in clinical approach, potentially driven by greater diagnostic uncertainty in non-DPN patients and highlight the need for tailored care pathways based on underlying etiologies.


Figure: The characteristics of gastroparesis hospitalizations with and without diabetic polyneuropathy


Figure: Length of stay and total charges in gastroparesis hospitalizations with and without diabetic polyneuropathy within the overlap population

Disclosures:
Anjul Verma indicated no relevant financial relationships.
Avneet Kaur indicated no relevant financial relationships.
Guy Loic Nguefang Tchoukeu indicated no relevant financial relationships.
Sameer Rao indicated no relevant financial relationships.
Edgar Luna Landa indicated no relevant financial relationships.
Hayden Mathews indicated no relevant financial relationships.
Lauren Glover indicated no relevant financial relationships.
Megan Mobley indicated no relevant financial relationships.
Sachi Khemka indicated no relevant financial relationships.
Virginia McGrath indicated no relevant financial relationships.
Vanya Rai indicated no relevant financial relationships.
Merry Mathew indicated no relevant financial relationships.
John Garza indicated no relevant financial relationships.

Anjul Verma, MD¹, Avneet Kaur, MBBS², Guy Loic Nguefang Tchoukeu, MD¹, Sameer Rao, MBBS³, Edgar Luna Landa, MD¹, Hayden Mathews, BS⁴, Lauren Glover, ⁴, Megan Mobley, ⁴, Sachi Khemka, MBA, BS⁵, Virginia McGrath, BS⁴, Vanya Rai, MBBS⁶, Merry Mathew, BS⁴, John Garza, PhD⁷. P4193 - The Hidden Burden of Non-Diabetic Gastroparesis: A Population-Based Study of Hospitalization Outcomes, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.