P0935 - Training Matters: How Trainee Skill Impacts Outcomes in Upper GI Bleeding - A Propensity-Matched US Study

Karan J.. Yagnik, MD¹, Sneh Sonaiya, MD, MPH, MBA², Raj H. Patel, MD³, Charmy Parikh, MD⁴, Umar Hayat, MD⁵, Rahul Kumar, MD⁶, Avinash Nankani, MBBS⁷, Pranav Patel, MD⁸, Dushyant S. Dahiya, MD⁹, Dhruvil Radadiya, MD¹⁰, Doantrang Du, MD¹, Ben Terrany, MD¹, Dhramesh Kaswala, MD¹, Bradley D. Confer, DO⁸, Harshit S. Khara, MD¹¹, Anish V. Patel, MD¹²
1Monmouth Medical Center, Robert Wood Johnson Medical School of Rutgers University, Long Branch, NJ; 2Kirk Kerkorian School of Medicine at the University of Nevada Las Vegas, Las Vegas, NV; 3St. Mary Medical Center, Langhorne, PA; 4Mercy Catholic Medical Center, Darby, PA; 5Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; 6North Central Bronx Hospital, Bronx, NY; 7Dow University of Health Sciences, Karachi, Sindh, Pakistan; 8Geisinger Health System, Danville, PA; 9University of Kansas School of Medicine, Kansas City, KS; 10Cedars-Sinai Medical Center, Los Angeles, CA; 11Geisinger Health System, Danville, NJ; 12Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ

Introduction: Previously studies have mentioned teaching hospitals have worse outcomes compared to non-teaching hospitals for patients with UGIB. Hence, we aim to study the impact of trainee experience on patient care by examining outcomes of upper gastrointestinal (GI) bleeding in teaching hospitals.

Methods: This study analyzed adult hospitalizations (age >18) with upper gastrointestinal bleeding (UGIB) in U.S. teaching hospitals using the National Inpatient Sample (2016–2020). Propensity score matching adjusted for baseline differences.

Results: A total of 666,105 patients were admitted with the diagnosis of UGIB in US teaching hospitals during our study time frame. Among 336,490 patients were admitted during the first quarter (July, Aug and Sept) and 329,615 patients were admitted during the last quarter (Apr, May and June) of the academic year. Primary outcomes showed higher mortality rate for NVUGIB (2.46% vs 2.08%, p=0.0020) during the last quarter of the academic year. It also had a higher incidence rate of ICU admission (4.54% vs 3.85%, p< 0.0001), CVC placement (1.64% vs 1.28%, p< 0.0001) and intubation (3.48% vs 3.04%, p=0.0032). For VUGIB, there was no difference for outcomes in between two quarters.

Discussion: We found inpatient hospital mortality, ICU admissions, CVC placement and intubation rates were higher for NVUGIB during the last quarter of the academic year. Junior trainees getting more autonomy during later phase of their training might be responsible for these disparities.


Figure: Comparison of Mortality rate for VUGIB and NVUGIB in First Quarter vs Last Quarter in US Teaching Hospitals (2016-2020).


Figure: Comparative Analysis of the Outcomes of the VUGIB and NVUGIB in First Quarter vs Last Quarter in US Teaching Hospitals (2016-2020).

Disclosures:
Karan Yagnik indicated no relevant financial relationships.
Sneh Sonaiya indicated no relevant financial relationships.
Raj Patel indicated no relevant financial relationships.
Charmy Parikh indicated no relevant financial relationships.
Umar Hayat indicated no relevant financial relationships.
Rahul Kumar indicated no relevant financial relationships.
Avinash Nankani indicated no relevant financial relationships.
Pranav Patel indicated no relevant financial relationships.
Dushyant Dahiya indicated no relevant financial relationships.
Dhruvil Radadiya indicated no relevant financial relationships.
Doantrang Du indicated no relevant financial relationships.
Ben Terrany indicated no relevant financial relationships.
Dhramesh Kaswala indicated no relevant financial relationships.
Bradley Confer indicated no relevant financial relationships.
Harshit Khara indicated no relevant financial relationships.
Anish Patel indicated no relevant financial relationships.

Karan J.. Yagnik, MD¹, Sneh Sonaiya, MD, MPH, MBA², Raj H. Patel, MD³, Charmy Parikh, MD⁴, Umar Hayat, MD⁵, Rahul Kumar, MD⁶, Avinash Nankani, MBBS⁷, Pranav Patel, MD⁸, Dushyant S. Dahiya, MD⁹, Dhruvil Radadiya, MD¹⁰, Doantrang Du, MD¹, Ben Terrany, MD¹, Dhramesh Kaswala, MD¹, Bradley D. Confer, DO⁸, Harshit S. Khara, MD¹¹, Anish V. Patel, MD¹². P0935 - Training Matters: How Trainee Skill Impacts Outcomes in Upper GI Bleeding - A Propensity-Matched US Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.