S1354 Training Matters: How Trainee Skill Impacts Outcomes in Upper GI Bleeding—A Propensity-Matched US Study

Introduction: Previously studies have mentioned teaching hospitals have worse outcomes compared to non-teaching hospitals for patients with UGIB. Hence, we aim to study the impact of trainee experience on patient care by examining outcomes of upper gastrointestinal (GI) bleeding in teaching hospitals. Methods: This study analyzed adult hospitalizations (age >18) with upper gastrointestinal bleeding (UGIB) in U.S. teaching hospitals using the National Inpatient Sample (2016–2020). Propensity score matching adjusted for baseline differences. Results: A total of 666,105 patients were admitted with the diagnosis of UGIB in US teaching hospitals during our study time frame. Among 336,490 patients were admitted during the first quarter (July, Aug and Sept) and 329,615 patients were admitted during the last quarter (Apr, May and June) of the academic year. Primary outcomes showed higher mortality rate for NVUGIB (2.46% vs 2.08%, P = 0.0020) during the last quarter of the academic year. It also had a higher incidence rate of ICU admission (4.54% vs 3.85%, P < 0.0001), CVC placement (1.64% vs 1.28%, P < 0.0001) and intubation (3.48% vs 3.04%, P = 0.0032). For VUGIB, there was no difference for outcomes in between 2 quarters. Conclusion: We found inpatient hospital mortality, ICU admissions, CVC placement and intubation rates were higher for NVUGIB during the last quarter of the academic year. Junior trainees getting more autonomy during later phase of their training might be responsible for these disparities.