S991 Weekend Admissions for Food Impaction and Foreign Body Ingestion Are Associated With Delays in Endoscopy but Without Increased Mortality or Major Complication Risk

Introduction: Prior studies have identified a “weekend effect” wherein patients admitted on weekends for gastroenterological emergencies face delays or worse outcomes compared to those admitted during weekdays. We wanted to determine whether or not a weekend effect exists for patients hospitalized with esophageal food impaction or foreign body ingestion. Methods: We performed a retrospective cohort analysis using the National Inpatient Sample (NIS) from 2016-2022. Adult patients (≥18 years) admitted non-electively with esophageal food impaction or foreign body ingestion were identified using validated International Classification of Diseases-10-CM codes. We compared demographics, hospital characteristics, timing of endoscopy, and outcomes between weekend and weekday admissions. Survey-weighted analyses were used to generate nationally representative estimates. Multivariate regression analyses were used to adjust for demographics, Charlson comorbidity index and hospital features (region, size, teaching status, location). Results: There were 50,160 weighted food impactions and 48,715 weighted foreign body ingestion admissions, of whom 28% (13,995) and 26% (12,670), respectively, were hospitalized on weekends. Weekend patients were slightly younger for both food impaction (68.1 vs 69.2 years) and foreign body ingestion (51.2 vs 53.0 years). Overall, 85.8% of food impaction and 50.2% of foreign body ingestion cases underwent esophagogastroduodenoscopy (EGD). The mean time to EGD was 1.02 days for food impaction (1.06 days for weekend vs 1.01 days for weekday admissions) and 2.25 days for foreign body ingestion (2.33 days for weekend vs 2.22 days for weekday admissions). Weekend admissions were associated with lower odds of early EGD (≤24 hr) for food impaction (adjusted odds ratio [aOR] 0.90; 95% confidence interval [CI] 0.82-0.995; P = 0.04) and foreign body ingestion (aOR 0.88; 95% CI 0.79-0.98; P = 0.02). No significant differences were observed in hospital mortality, esophageal perforation, aspiration pneumonia, acute respiratory failure or mechanical ventilation on weekend vs weekday admissions. Conclusion: Weekend admissions for esophageal food impaction or foreign body ingestion were associated with delayed endoscopy, with significantly lower odds of early EGD. However, this delay did not lead to higher rates of mortality or major complications. These findings suggest a procedural weekend effect without adverse clinical impact.