Umesh Bhagat, MD1, Mohamed Abdelbaky, MD2, Ankit Agrawal, 3, Archana Kharel, MD3, Archit Garg, MD4, Prabhat Kumar, MD5, Sukul Khanna, MBBS6, Luisa Recinos, MD7 1Cleveland Clinic Foundation, Cleveland, OH; 2Presbyterian Health care, Albuquerque, NM; 3Cleveland Clinic, Cleveland, OH; 4Saint Peter's University Hospital / Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; 5Virginia Commonwealth University, Richmond, VA; 6University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, Delhi, India; 7Saint Peter's University Hospital / Rutgers Robert Wood Johnson Medical School, Somerset, NJ Introduction: Gastroparesis is a chronic, debilitating condition characterised by delayed gastric emptying. Gastric peroral endoscopic myotomy (G-POEM) has recently emerged as a novel therapeutic option for managing gastroparesis. The data regarding 30-day readmission rates is lacking. Here we attempt to identify rates of 30 days admission based on their day of discharge. Methods: National Readmission Database (NRD) 2016-2021 was queried to identify patients undergoing G-POEM for gastroparesis. The primary outcome was the incidence of 30-day readmission based on discharge day, categorised as same-day discharge (SDD), next-day discharge (NDD), and second-day discharge or beyond (ScDD). Survival analysis was done to find the cumulative incidence of readmission. Statistical analysis was performed using R programming Results: A total of 807 patients were included in the study. Among them, 23 were SDD, 262 were NDD and 518 were ScDD. The mean age for SDD was 45.87 years and 75.92% were females. The mean age for NDD was 50.39 years and 65.82% were females. The mean age of ScDD was 49.61 and 78.09% were females. Majority of the procedures in all of the three cohorts were done in a large metropolitan teaching hospital (100% vs 95.80% vs 97.40%). The cumulative incidence for readmission for the SDD and NDD cohort was 15% and 6.0% respectively with P=0.2. The cumulative incidence for readmission for the SDD and ScDD cohorts was 15% and 17%, respectively, with P=0.9. The cumulative incidence for readmission for the NDD and ScDD cohorts was 6.0% and 17%, respectively, with P< 0.001. Discussion: Based on this study, which utilises a large national database, next day discharge appears to be the safest based on the low risk of readmission at 30 days. The same day discharge while potentially could be safe in selected population, will need larger studies to validate the safety due to limited data. Second day discharge is associated with the highest cumulative risk of readmission likely due to the patient factors which necessitated the prolonged hospitalisation in the index admission. Discharge timing should be individualised based on patients’ characteristics and comorbidities, and the feasibility of same-day vs next-day discharge warrants further evaluation.
Figure: Cumulative risk of readmission
Disclosures: Umesh Bhagat indicated no relevant financial relationships. Mohamed Abdelbaky indicated no relevant financial relationships. Ankit Agrawal indicated no relevant financial relationships. Archana Kharel indicated no relevant financial relationships. Archit Garg indicated no relevant financial relationships. Prabhat Kumar indicated no relevant financial relationships. Sukul Khanna indicated no relevant financial relationships. Luisa Recinos indicated no relevant financial relationships.
