Clinical Endoscopy

Hemant Goyal

2 Articles

Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States: Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma; Clin Endosc 2023;56(3):340-352. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2022.166

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Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods
We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results
From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions
Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

Citations

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Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh
Clinics in Colon and Rectal Surgery.2024; 37(06): 398. CrossRef
Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz
European Journal of Therapeutics.2024; 30(3): 303. CrossRef
Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik
Caucasian Medical Journal.2023; 1(3): 36. CrossRef

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A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States: Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai, Nihar Shah; Clin Endosc 2019;52(5):486-496. Published online May 27, 2019; DOI: https://doi.org/10.5946/ce.2018.190

Abstract PDF PubReader ePub

Background
/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the “July effect”.
Methods
The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.
Results
Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.
Conclusions
The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

Citations

Citations to this article as recorded by

The July Effect on Mortality, Hospital Length of Stay, and Time to Colonoscopy Among Patients Presenting to Teaching Hospitals With LGIB in the United States
Eugene Annor, Chima Amadi, Joseph Atarere, Nneoma Ubah, Oluwatayo J. Awolumate, Adedeji Adenusi, Geraldine Nabiryo Nabeta, Darrell Downs, Ayokunle T. Abegunde
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef
A Nationwide Study of the “July Effect” Concerning Postpartum Hemorrhage and Its Risk Factors at Teaching Hospitals across the United States
Zahra Shahin, Gulzar H. Shah, Bettye A. Apenteng, Kristie Waterfield, Hani Samawi
Healthcare.2023; 11(6): 788. CrossRef
July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States
Karthik Gangu, Sanket Basida, Rehmat Ullah Awan, Mohammad Ali Butt, Austin Reed, Rao Afzal, Rahul Shekhar, Harleen Kaur Chela, Ebubekir S. Daglilar, Abu Baker Sheikh
Baylor University Medical Center Proceedings.2023; 36(4): 478. CrossRef
Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?
Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami
Clinical Endoscopy.2022; 55(3): 426. CrossRef
Post-ERCP Pancreatitis: Prevention, Diagnosis and Management
Oscar Cahyadi, Nadeem Tehami, Enrique de-Madaria, Keith Siau
Medicina.2022; 58(9): 1261. CrossRef
Risk factors for infections after endoscopic retrograde cholangiopancreatography (ERCP): a retrospective cohort analysis of US Medicare Fee-For-Service claims, 2015–2021
Susan Hutfless, Yasutoshi Shiratori, Daniel Chu, Simon Liu, Anthony Kalloo
BMJ Open.2022; 12(9): e065077. CrossRef
Clinical coaches and patient safety – Just in time: A descriptive exploratory study
Lorraine Thompson, Frances Lin, Annette Faithfull-Byrne, Judith Gonzalez, Amanda Naumann, Kathryn Geisler, Cheryle Moss
Nurse Education in Practice.2021; 54: 103134. CrossRef
Is the July Effect Real in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography?
Tae Yoon Lee, Yousuke Nakai
Clinical Endoscopy.2019; 52(5): 399. CrossRef

6,677 View
85 Download
7 Web of Science
8 Crossref

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