S1194 Impact of Cirrhosis on In-Hospital Outcomes Among Patients With Gastrointestinal Motility Disorders: A Nationwide Analysis

Introduction: Cirrhosis is associated with systemic complications that may exacerbate the course of coexisting gastrointestinal (GI) motility disorders. However, limited data exist on how cirrhosis may influence in-hospital outcomes in this population. In this study we aim to evaluate the association between cirrhosis and clinical outcomes in hospitalized patients with GI motility disorders. Methods: The United States Nationwide Inpatient Sample (NIS) database was used to extract data of patients admitted between 2019 to 2021. Using ICD10 codes, we identified adults with different GI motility disorders; gastroparesis, gastroesophageal reflux disease (GERD), dyspepsia, achalasia and irritable bowel syndrome (IBS). Patients were divided according to cirrhosis status. The primary outcome was the in-hospital mortality. Secondary outcomes included sepsis, acute kidney injury (AKI), hyponatremia, malnutrition and ileus. Multivariate logistic regression was used to adjust for relevant variables. Results: Our study found that among the 212,067 hospitalized patients with cirrhosis, 42,101 were diagnosed with GERD, 1317 with gastroparesis, 58 with achalasia, 139 with dyspepsia, and 1092 with IBS. Cirrhosis was independently associated with an increased chance of in-hospital mortality across all motility disorders. The adjusted odds ratios (aOR) for mortality were 2.15 for gastroparesis, 9.03 for achalasia, 4.42 for dyspepsia, 2.81 for IBS, and 2.81 for GERD (P < 0.001). Further, cirrhosis was linked to higher odds of AKI and hyponatremia in all GI motility disorders. In addition, the chance of malnutrition was increased in all patients except those with dyspepsia. Cirrhosis also increased the chance of sepsis in patients with gastroparesis, IBS and GERD as well as the chance of ileus in patients with achalasia only. Conclusion: Our findings indicate that cirrhosis serves as a significant independent predictor of in-hospital mortality and adverse clinical outcomes in patients hospitalized with various gastrointestinal motility disorders. These results underscore the need for early risk stratification and the implementation of targeted management strategies to improve the quality of care for patients with cirrhosis and coexisting motility disorders.