S896 Impact of Hospital Type and Geographic Region on In-Hospital Mortality in Patients With Esophageal Varices: Insights From the National Inpatient Sample

Introduction: Esophageal varices, a consequence of portal hypertension, are associated with significant morbidity and mortality, often requiring urgent inpatient management. While clinical factors have been well-studied, structural and regional healthcare disparities may also influence patient outcomes. This study examines the relationship between hospital teaching status, geographic region, and in-hospital mortality among patients admitted with esophageal varices through a national cohort analysis. Methods: Data from the National Inpatient Sample (NIS) database from 2019 to 2021 were analyzed to identify adult patients admitted with a primary diagnosis of esophageal varices. Multivariate logistic was used to adjust for confounders. In-hospital mortality was analyzed based on hospital teaching status (rural, urban non-teaching, urban teaching) and regions (Northeast, Midwest, South, West). STATA software was utilized for statistical analysis. Results: A total of 30,889 patients were hospitalized with a primary diagnosis of esophageal varices between 2019 and 2021. In-hospital mortality varied significantly based on hospital teaching status. Patients admitted to rural hospitals had the lowest mortality rate at 5.7%, followed by those at urban non-teaching hospitals at 7.1%, while urban teaching hospitals reported the highest mortality at 9.0% (P = 0.0160). Mortality also differed significantly across geographic regions (P = 0.0261). The Northeast reported the highest in-hospital mortality rate at 11.0%, followed by the West at 8.4%, the South at 7.9%, and the Midwest at 7.6%. Conclusion: This national analysis reveals significant disparities in in-hospital mortality among patients admitted with esophageal varices based on hospital type and geographic region. Higher mortality rates were observed in the urban teaching hospitals and in the Northeast region. These differences may represent variations in healthcare infrastructure, patient acuity, and access to care. Further investigation into healthcare system differences and regional practice patterns may help guide future changes aimed at improving outcomes for patients with esophageal varices across diverse care settings.