S979 Safety Outcomes of Radiofrequency Ablation for Barrett's Esophagus in Patients With Cirrhosis Versus Non-Cirrhotic Controls: A Propensity-Matched Analysis

Introduction: Radiofrequency ablation (RFA) is a standard treatment for Barrett's esophagus (BE). However, its safety profile and resource utilization in patients with cirrhosis, who may be at higher risk for complications, remains poorly characterized. Methods: Using a large healthcare database, we conducted a propensity score-matched analysis comparing 30-day outcomes between BE patients with cirrhosis (N = 373) and without cirrhosis (N = 373) undergoing RFA. Primary outcomes included post-procedure adverse events and healthcare resource utilization. Results: Baseline characteristics were well-matched between cirrhotic and non-cirrhotic groups, including age (64.8 ± 9.5 years vs 64.7 ± 10.6 years; P = 0.904), gender distribution (25.7% vs 27.6% women; P = 0.562), and comorbidities such as hypertension (70.2% vs 72.4%, P = 0.517) and diabetes (47.2% vs 49.1%; P = 0.608). At 30 days, cirrhotic patients demonstrated significantly higher rates of gastrointestinal bleeding (adjusted odds ratio [aOR] 3.997; 95% confidence interval [CI] 1.957-8.164; P < 0.0001) and need for repeat endoscopy (aOR 2.536; 95% CI 1.274-5.05; P = 0.006). Healthcare utilization was also increased in the cirrhotic group, with higher rates of emergency department presentations (aOR 1.898; 95% CI 1.032-3.493; P = 0.0367) and hospitalizations (aOR 2.585; 95% CI 1.535-4.351; P = 0.0002). However, there were no significant differences in blood transfusion requirements (aOR 1.0; 95% CI 0.411-2.432; P = 1.0) or intensive care utilization (aOR 1.311; 95% CI 0.567-3.028; P = 0.5252). Conclusion: Patients with cirrhosis undergoing RFA for BE experience significantly higher rates of gastrointestinal bleeding and healthcare utilization compared to non-cirrhotic patients. These findings suggest the need for enhanced risk stratification and post-procedure monitoring protocols specific to the cirrhotic population undergoing RFA.