S1193 Comorbid Anxiety and Its Impact on Hospital Outcomes in Patients With Disorders of Gut-Brain Interaction: A Nationwide Study

Introduction: Disorders of gut-brain interaction (DGBI), including gastroparesis, irritable bowel syndrome (IBS), and dyspepsia, are frequently associated with psychiatric comorbidities such as anxiety. However, the impact of anxiety on hospitalization outcomes in DGBI remains underexplored. This study aimed to assess the influence of comorbid anxiety on in-hospital outcomes in patients admitted with DGBI. Methods: We conducted a retrospective cohort study using the National Inpatient Sample (NIS) from 2019 to 2021. Adult patients hospitalized with a diagnosis of gastroparesis, IBS, or dyspepsia were identified using International Classification of Diseases codes and stratified based on the presence or absence of comorbid anxiety. Demographic and clinical characteristics, in-hospital mortality, length of stay (LOS), and total hospital charges were analyzed. Multivariate logistic regression was used to determine anxiety as an independent predictor of clinical outcomes. Results: Among 2,682,412 patients with anxiety, 39,132 (25.6%) had gastroparesis, 62,739 (36.7%) had IBS, and 4226 (10.7%) had dyspepsia. Patients with anxiety were younger, predominantly females, and had lower in-hospital mortality rates compared to their counterparts without anxiety. In gastroparesis group, anxiety was associated with reduced hospitalization costs ($65,399 vs $72,787), with no significant difference in LOS (5.9 vs 6.0 days). In IBS, anxiety was associated with slightly longer LOS (4.97 vs 4.66 days), and marginally lower charges. In dyspepsia, anxiety was associated with increased LOS (8.99 vs 8.46 days) and lower hospitalization costs. On multivariate analysis, anxiety was independently associated with decreased mortality chance in gastroparesis patients (aOR 0.673, P < 0.001), but not in IBS or dyspepsia. Anxiety was also an independent predictor of increased LOS in patients with dyspepsia (aOR 1.46, P = 0.03) and IBS (aOR 1.10, P = 0.001), but not in gastroparesis. Conclusion: Anxiety is a significant modifier of clinical outcomes in patients hospitalized with disorders of gut-brain interaction. While associated with reduced mortality in gastroparesis patients, anxiety also contributed to longer hospital stays in IBS and dyspepsia patients. These findings underscore the importance of integrating psychiatric evaluation in the management of patients with DGBI.