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
{"title":"精神因素对胃轻瘫患者卫生保健资源利用的影响：一项基于全国人群的研究","authors":"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","doi":"10.1016/j.gastha.2025.100620","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em> < .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, <em>P</em> < .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100620"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study\",\"authors\":\"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\",\"doi\":\"10.1016/j.gastha.2025.100620\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>P</em> < .001) and a longer median hospital stay (4, interquartile range: 2–6 vs 3, interquartile range: 2–6, <em>P</em> < .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":73130,\"journal\":{\"name\":\"Gastro hep advances\",\"volume\":\"4 5\",\"pages\":\"Article 100620\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gastro hep advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S277257232500007X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastro hep advances","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S277257232500007X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的胃轻瘫以胃排空延迟为特征，可导致衰弱的胃肠道症状，并常伴有精神疾病，可能与脑-肠网络功能障碍有关。这对生活质量产生不利影响，需要医疗护理。我们的目的是表征共病焦虑、抑郁或双相情感障碍对主要因胃轻瘫住院的成人医疗资源利用的纵向影响。方法利用2016-2019年全国住院患者样本医疗成本和利用项目，对年龄≥18岁、指数诊断为胃轻瘫（国际疾病分类-10代码K31.84）的住院患者进行回顾性观察研究。该队列根据共病精神情绪障碍（抑郁、焦虑和双相情感障碍）的存在进行分层。我们比较了计算机断层扫描（CT）成像频率、胃排空研究、内窥镜检查、住院时间和住院费用。采用卡方检验和方差分析检验。结果47,265例胃轻瘫住院患者中，21,545例（45.6%）合并精神情绪障碍。这些患者的平均Elixhauser合并症指数更高（3.6±1.8 vs 2.9±1.8），P <；.001)和更长的住院时间中位数(4，四分位数范围：2-6 vs 3，四分位数范围：2-6，P <；措施)。校正分析显示本组CT显像频率较高(校正优势比：1.15；95%置信区间：1.04-1.67)。虽然内窥镜手术的频率、胃造影和总住院费用在精神共病组较高，但这些差异在单变量分析中没有统计学意义。结论近50%的胃轻瘫患者伴有精神疾病，且CT显像频率较高，住院时间较长。这强调了在所有胃轻瘫患者入院时筛查精神疾病的重要性，并探索将社会心理干预纳入胃轻瘫患者治疗计划的有效性。
The Influence of Psychiatric Factors on Health-Care Resource Utilization in Patients With Gastroparesis: A National Population-Based Study
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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