The Conundrum of Obesity and Gastroparesis Hospitalizations: A Retrospective Comparative Analysis of Hospitalization Characteristics and Disparities Amongst Socioeconomic and Racial Backgrounds in the United States

Dushyant S Dahiya; Sumant Inamdar; Abhilash Perisetti; Hemant Goyal; Amandeep Singh; Rajat Garg; Chin-I Cheng; Asim Kichloo; Mohammad Al-Haddad; Neil Sharma

doi:10.5056/jnm21232

The Conundrum of Obesity and Gastroparesis Hospitalizations: A Retrospective Comparative Analysis of Hospitalization Characteristics and Disparities Amongst Socioeconomic and Racial Backgrounds in the United States

J Neurogastroenterol Motil. 2022 Oct 30;28(4):655-663. doi: 10.5056/jnm21232.

Authors

Dushyant S Dahiya¹, Sumant Inamdar², Abhilash Perisetti³, Hemant Goyal^{4

5}, Amandeep Singh⁶, Rajat Garg⁶, Chin-I Cheng⁷, Asim Kichloo¹, Mohammad Al-Haddad⁸, Neil Sharma^{8

9}

Affiliations

¹ Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI, USA.
² Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
³ Parkview Cancer Institute, Fort Wayne, IN, USA.
⁴ The Wright Center for Graduate Medical Education, Scranton, PA, USA.
⁵ Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.
⁶ Department of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic Foundation, Cleveland, OH, USA.
⁷ Central Michigan University College of Science and Engineering, Mt Pleasant, MI, USA.
⁸ Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
⁹ Division of Interventional Oncology and Surgical Endoscopy (IOSE), Parkview Cancer Institute, Fort Wayne, IN, USA.

Abstract

Background/aims: We aim to assess the influence of obesity on gastroparesis (GP) hospitalizations in the United States (US).

Methods: The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of GP. They were subdivided based on the presence or absence of obesity (body mass index > 30). Hospitalization characteristics, procedural differences, all-cause inpatient mortality, mean length of stay (LOS), and mean total hospital charge (THC) were identified and compared.

Results: From 2007-2017, there were 140 293 obese GP hospitalizations accounting for 13.75% of all GP hospitalizations in the US. Obese GP hospitalizations were predominantly female (76.11% vs 64.36%, P < 0.001) and slightly older (51.9 years vs 50.8 years, P < 0.001) compared to the non-obese cohort. Racial disparities were noted as Blacks (25.49% vs 22%, P < 0.001) had higher proportions of GP hospitalizations with obesity compared to the non-obese cohort. Furthermore, we noted higher rates of inpatient upper endoscopy utilization (6.05% vs 5.42%, P < 0.001), longer mean LOS (5.71 days vs 5.32 days, P < 0.001), and higher mean THC ($53 373 vs $45 040, P < 0.001) for obese GP hospitalizations compared to the non-obese group. However, obese GP hospitalizations had lower rates of inpatient mortality (0.92% vs 1.33%, P < 0.001), and need for nutritional support with endoscopic jejunostomy (0.25 vs 0.56%, P < 0.001) and total parenteral nutrition (1.46% vs 2.33%, P < 0.001) compared to the non-obese cohort.

Conclusions: In the US, compared to non-obese, a higher proportion of obese GP hospitalizations were female and Blacks. Obese GP hospitalizations also had higher THC, LOS, and rates of upper endoscopy.

Keywords: Cost; Gastroparesis; Mortality; Obesity; Outcomes.