The Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study

Karan Sachdeva , Daniyal Raza , Lovekirat Singh Dhaliwal , Rohit Goyal , Pooja Shah , Lena Kawji , Ashley Deville , Brittany Pass , Natalie Roppolo , Ahmad Alkurd , Farhan Mohiuddin , Hailey Canezaro , Victoria Andrus , Elizabeth Armstrong , Michelle Neice , Maryam Mubashir , Shazia Rashid , Michael Tran , Omar Khan , Qiang Cai
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Abstract

Background and Aims

Gastroparesis, characterized by delayed gastric emptying, leads to debilitating gastrointestinal symptoms and often experience comorbid psychiatric disorders, possibly linked to brain-gut network dysfunction. This adversely affects quality of life and necessitates medical care. We aimed to characterize the longitudinal impact of comorbid anxiety, depression, or bipolar disorder on health-care resource utilization in adults hospitalized primarily with gastroparesis.

Methods

A retrospective observational study using the 2016–2019 National Inpatient Sample Healthcare Cost and Utilization Project identified patients aged ≥18 years hospitalized with an index diagnosis of gastroparesis (International Classification of Diseases-10 code K31.84). The cohort was stratified based on the presence of comorbid psychiatric mood disorders (depression, anxiety, and bipolar spectrum disorders). We compared the frequency of computed tomography (CT) imaging, gastric emptying studies, endoscopic procedures, length of stay, and hospitalization costs. Chi-square and analysis of variance tests were used.

Results

Of 47,265 patients hospitalized with gastroparesis, 21,545 (45.6%) had comorbid psychiatric mood disorders. These patients had a higher mean Elixhauser comorbidity index (3.6 ± 1.8 vs 2.9 ± 1.8, P < .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, P < .001). Adjusted analysis showed higher CT imaging frequency in this group (adjusted Odds ratio: 1.15; 95% confidence interval: 1.04–1.67). Although the frequency of endoscopic procedures, gastric scintigraphy, and total hospitalization costs were higher in the psychiatric comorbidity group, these differences were not statistically significant in univariable analysis.

Conclusion

Nearly 50% of gastroparesis patients had concurrent psychiatric disorders and underwent more frequent CT imaging and had longer hospital stays. This underscores the importance of screening all gastroparesis patients for psychiatric disorders upon admission and exploring the effectiveness of incorporating psychosocial interventions into the treatment plan for gastroparesis patients.
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Gastro hep advances
Gastro hep advances Gastroenterology
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