S2221 Discharge Trends After Gastric Peroral Endoscopic Myotomy

Introduction: Gastroparesis is a chronic, debilitating condition characterised by delayed gastric emptying. Gastric peroral endoscopic myotomy (G-POEM) has recently emerged as a novel therapeutic option for managing gastroparesis. The data regarding 30-day readmission rates is lacking. Here we attempt to identify rates of 30 days admission based on their day of discharge. Methods: National Readmission Database (NRD) 2016-2021 was queried to identify patients undergoing G-POEM for gastroparesis. The primary outcome was the incidence of 30-day readmission based on discharge day, categorised as same-day discharge (SDD), next-day discharge (NDD), and second-day discharge or beyond (ScDD). Survival analysis was done to find the cumulative incidence of readmission. Statistical analysis was performed using R programming. Results: A total of 807 patients were included in the study. Among them, 23 were SDD, 262 were NDD and 518 were ScDD. The mean age for SDD was 45.87 years and 75.92% were women. The mean age for NDD was 50.39 years and 65.82% were women. The mean age of ScDD was 49.61 and 78.09% were women. Majority of the procedures in all of the 3 cohorts were done in a large metropolitan teaching hospital (100% vs 95.80% vs 97.40%). The cumulative incidence for readmission for the SDD and NDD cohort was 15% and 6.0% respectively with P = 0.2. The cumulative incidence for readmission for the SDD and ScDD cohorts was 15% and 17%, respectively, with P = 0.9. The cumulative incidence for readmission for the NDD and ScDD cohorts was 6.0% and 17%, respectively, with P < 0.001. Conclusion: Based on this study, which utilises a large national database, next day discharge appears to be the safest based on the low risk of readmission at 30 days. The same day discharge while potentially could be safe in selected population, will need larger studies to validate the safety due to limited data. Second day discharge is associated with the highest cumulative risk of readmission likely due to the patient factors which necessitated the prolonged hospitalisation in the index admission. Discharge timing should be individualised based on patients’ characteristics and comorbidities, and the feasibility of same-day vs next-day discharge warrants further evaluation.