Helicobacter Pylori Associated Gastro-intestinal Bleeding In Bariatric Surgery – Nationwide-survey

Palabindela, Prasannalaxmi

HELICOBACTER PYLORI ASSOCIATED GASTRO-INTESTINAL BLEEDING IN BARIATRIC SURGERY – NATIONWIDE-SURVEY

Asal Hojjat, MD¹, Brandon Pena, MD², Himani Bhatt, MBBS³, Neev Mehta, MBBS MPH⁴, Dimpy Mehta, MuDr⁵, Sujashree Yadala Venkata, MBChB⁶, Sunday Ogbue, MD MPH⁷, Aaron Goyal, MBBS⁸, Khushboo Tanwar, MBBS⁹, Rajeev Sai Moram, MBBS¹⁰, Krina Viroliya, MD¹¹, Md Ziauddin, MD¹², Uvesh Mansuri, MD MPH¹³, Urvish Patel, MD, MPH¹⁴, Prasannalaxmi Palabindela, MD¹⁵, ¹Department of Urology, Boston Children's Hospital, Boston, MA, ; ²Desai Sethi Urology Institute, University of Miami, Miami, Fl, 33136, USA, ; ³Research Fellow, Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, 55905, USA, ; ⁴Department of Gastroenterology, Lahey Hospital and Medical Center, Burlington, MA, USA, ; ⁵First Faculty of Medicine, Charles University, ; ⁶University of Glasgow, Glasgow G12 8QQ, Scotland, United Kingdom, ; ⁷Department of Public Health and Health Sciences,University of Massachusetts, Amherst,MA 01003, USA, NY, Glen Oaks; ⁸Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605006, India, ; ⁹Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, 221005, India, ; ¹⁰Mediciti institute of medical sciences, Ghanpur , Hyderabad, Telangana, 501401, India, ; ¹¹University of Houston College of Medine/HCA Houston Healthcare Kingwood, Texas, 77339, USA, TX, Kingwood; ¹²Department of Medicine, Metropolitan Hospital, New york city, NY, 10029 USA, ; ¹³Department of Medicine, MedStar Harbor Hospital, Baltimore, MD, 21225 USA, ; ¹⁴Icahn School of Medicine at Mount Sinai, New York, NY, USA, ; ¹⁵Department of Internal Medicine, Jennie Stuart Health, Hopkinsville, KY 42240, USA,

Meeting: SHM Converge 2023

Abstract Number: 150

Category: Research

Sub-Category: Outcomes Research

Keywords: Bariatric Surgery, Gastro Intestinal Bleeding, Helicobacter Pylori, Hospital Medicine, Obesity

Background: A higher Helicobacter pylori (H. pylori) prevalence was associated with increased rates of post-operative complications including increased marginal ulceration and leak rates. Limited studies described prevalence of H. pylori in patients undergoing bariatric surgery and H. pylori associated upper and lower gastrointestinal bleeding (GIB). Primary Aim of our study was to evaluate the prevalence of GIB in patients with H. pylori infection undergoing bariatric surgery. The secondary aim of the study was to identify odds of having GIB in patients with H. pylori infection in comparison without H. pylori infection.

Methods: A retro-spective cross-sectional observational study from nationwide inpatient sample (2007-2018) was planned amongst morbid obese adults undergoing bariatric surgery (Open roux-en-y gastric bypass, laparoscopic roux-en-y gastric bypass, laparoscopic adjustable gastric banding). Bariatric surgeries, H. pylori infection, GIB were identified using ICD 10 codes. Univariate analysis using chi-square test and unpaired t test and multivariate analysis using mix-effects survey logistic regression modeling were performed to find out prevalence and association of GIB among patients with H. pylori infection in comparison without H. pylori infection. Adjusted odds ratio (aOR) with 95% confidence interval (95%CI) were calculated using alpha criteria of 0.05 as statistically significant.

Results: Out of 167795 who underwent bariatric surgery, 1204 (0.72%) had GIB and 480 (0.29) had H. pylori infection. Patients with H. pylori were more older (51 vs 47-years old), 50-75 years age group (12.5% vs 2.5%), Black race (26.6% vs 15.4%), Hispanic race (26.6% vs 13.9%), lower median household income 0-25 percentile (44.6% vs 26.2%), having medicare (32.3% vs 19.2%), hypertensives (57% vs 56%), and CHF (4.2% vs 2.7%) in comparison to those without H. pylori. Prevalence of GIB was higher in H. pylori (9.37% vs 0.69%) in comparison without H. pylori . In demographics and comorbidity adjusted regression analysis, patients with H. pylori were associated with 143% higher (aOR 2.43, 95%CI 1.60-3.71, p< 0.0001) odds of GIB in comparison with patients without H. pylori. (c value/ ROC =0.94)

Conclusions: H. pylori infection had increased risk-adjusted occurrence of GIB amongst patients undergoing bariatric surgery. H. pylori testing may improve risk stratification for GIB and lower the health care cost burden. This cross-sectional study was confounded by disease severity, follow up, and causality between H. pylori and GIB.

By admin|2023-04-05T15:54:22-05:00April 5th, 2023|

To cite this abstract:

Asal Hojjat, MD¹, Brandon Pena, MD², Himani Bhatt, MBBS³, Neev Mehta, MBBS MPH⁴, Dimpy Mehta, MuDr⁵, Sujashree Yadala Venkata, MBChB⁶, Sunday Ogbue, MD MPH⁷, Aaron Goyal, MBBS⁸, Khushboo Tanwar, MBBS⁹, Rajeev Sai Moram, MBBS¹⁰, Krina Viroliya, MD¹¹, Md Ziauddin, MD¹², Uvesh Mansuri, MD MPH¹³, Urvish Patel, MD, MPH¹⁴, Prasannalaxmi Palabindela, MD¹⁵.

HELICOBACTER PYLORI ASSOCIATED GASTRO-INTESTINAL BLEEDING IN BARIATRIC SURGERY – NATIONWIDE-SURVEY.

Abstract published at SHM Converge 2023.

Abstract 150

Journal of Hospital Medicine.

https://shmabstracts.org/abstract/helicobacter-pylori-associated-gastro-intestinal-bleeding-in-bariatric-surgery-nationwide-survey/.

April 25th 2024.

HELICOBACTER PYLORI ASSOCIATED GASTRO-INTESTINAL BLEEDING IN BARIATRIC SURGERY – NATIONWIDE-SURVEY

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