Marshall University Joan C. Edwards School of Medicine Huntington, WV
Bassel Dakkak, MD1, Yasmeen Obeidat, MD1, Abdelwahap Elghezewi, MD2, Tareq Alsaleh, MD3, Jennifer L. Wiese, MD1, Hafiz Zarsham Ali Ikram, MD1, Yasir Rajwana, MD1, Ahmed Sherif, MD1, Wesam Frandah, MD1 1Marshall University Joan C. Edwards School of Medicine, Huntington, WV; 2Marshall University Joan C. Edwards School of Medicine, Barboursville, WV; 3Department of Internal Medicine, AdventHealth Orlando, Orlando, FL Introduction: Eosinophilic esophagitis (EoE) is a chronic immune-mediated esophageal disease that has seen increased recognition in recent years. Despite the growing burden of this disease, national trends in diagnosis rates and utilization of endoscopic dilative procedures remain underreported. This study aims to explore differences in patient and hospital characteristics among those undergoing dilative procedures using the Nationwide Inpatient Sample (NIS) database. Methods: We conducted a retrospective cohort study using the National inpatient sample (NIS) database from 2018 to 2021. Patients diagnosed with EoE were identified using ICD-10-CM code and were stratified based on undergoing endoscopic dilative procedure using ICD-10-PCS codes. T-test and chi-square test were used to compare patients and hospital characteristics between groups and logistic regression analysis was used to assess possible predictors. Survey weights were applied to account for the complex survey design of the NIS. Results: Among 27,390 EoE-related hospitalizations from 2018 to 2021, 1,345 (4.9%) patients underwent endoscopic dilation. Those who underwent dilation were significantly older (mean age: 51 vs. 36 years, p< 0.001) and more likely to have Medicare insurance (34.6% vs. 18.8%, p=0.001) or reside in the lowest income quartile (27.9% vs. 20.3%, p=0.001). Dilation was also more frequent in urban-teaching hospitals (77.7%). Asthma was less common among those receiving dilation (12.6% vs. 25.1%, p< 0.001), while smoking was more prevalent (12.2% vs. 5.5%). Multivariable regression confirmed that increasing age (OR 1.03, 95% CI: 1.02–1.04), smoking (OR 1.56, 95% CI: 1.04–2.34), and lower income (Q4 vs. Q1: OR 0.59, 95% CI: 0.39–0.88) were independently associated with dilation, while asthma was inversely associated (OR 0.63, 95% CI: 0.43–0.93). Discussion: EoE patients who underwent dilation were older and more often covered by Medicare, suggesting more advanced disease. Most procedures occurred at urban teaching hospitals, likely due to availability of advanced endoscopy. Higher dilation rates in lower-income groups may indicate delayed presentation possibly due to barriers in access to care. Smoking was more common and asthma less frequent among those dilated, possibly due to smoking-related GERD promoting strictures and asthma treatments improving EoE control. Further research is needed to better understand these associations and reduce related disparities.AI was used to refine language only.
Figure: Table 1. Baseline patient demographic and Hospital characteristics of EoE-related admissions stratified by undergoing endoscopic dilative procedures.
Figure: Table 2. Adjusted odds ratios and 95% confidence intervals from a multivariable logistic regression model assessing predictors of undergoing esophageal dilation among hospitalized patients with eosinophilic esophagitis (EoE).
Disclosures: Bassel Dakkak indicated no relevant financial relationships. Yasmeen Obeidat indicated no relevant financial relationships. Abdelwahap Elghezewi indicated no relevant financial relationships. Tareq Alsaleh indicated no relevant financial relationships. Jennifer Wiese indicated no relevant financial relationships. Hafiz Zarsham Ali Ikram indicated no relevant financial relationships. Yasir Rajwana indicated no relevant financial relationships. Ahmed Sherif indicated no relevant financial relationships. Wesam Frandah: Boston Scientific – Advisor or Review Panel Member, Consultant. Merritt – Consultant. Olympus corporation of America – Consultant.
Bassel Dakkak, MD1, Yasmeen Obeidat, MD1, Abdelwahap Elghezewi, MD2, Tareq Alsaleh, MD3, Jennifer L. Wiese, MD1, Hafiz Zarsham Ali Ikram, MD1, Yasir Rajwana, MD1, Ahmed Sherif, MD1, Wesam Frandah, MD1. P2752 - National Trends in Eosinophilic Esophagitis and Use of Endoscopic Dilation: A Nationwide Inpatient Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
