S3192 Diabetes Mellitus Transforms Gastroparesis Outcomes: A National Analysis of Mortality, Healthcare Utilization, and Cost Burden

Introduction: Gastroparesis (GP), a chronic gastric motility disorder, is frequently linked with diabetes mellitus (DM), potentially altering both its etiology and hospitalization outcomes. Patients with a feeding tube-associated GP represent a distinct high-risk subgroup. We aimed to assess associations between diabetes and in-hospital outcomes among patients hospitalized with GP, including those with feeding tubes. Methods: We analyzed the National Inpatient Sample (2017 to 2022) for GP hospitalizations, stratified by diabetes status. Multivariable regression models were adjusted for demographic, socioeconomic, and clinical factors using Stata 17. Outcomes were reported as adjusted coefficients for continuous variables and adjusted odds ratios (aORs) for binary outcomes. Results: Diabetic gastroparesis patients were predominantly men (78.97% vs 21.03%), older (77.86% ages 40-59 years), and non-White including Black (85.21%) and Hispanic (82.42%) patients (all P < 0.001). They were more frequently in the lowest income quartile (78.73%). Comorbidity burden was substantially higher in diabetic patients: hypertension (73.69%), obesity (79.88%), chronic kidney disease (89.28%), congestive heart failure (85.26%), stroke (81.76%), and myocardial infarction (85.65%) (all P < 0.001). Despite this elevated burden, diabetic patients had superior outcomes. Mortality was significantly reduced (aOR 0.45; 95% CI 0.42-0.49; P < 0.0001), hospital stay shortened by 2.48 days (95% CI -2.60 to -2.36; P < 0.0001), and charges decreased by $29,798 (95% CI -$31,426 to -$28,170; P < 0.0001). Among feeding tube patients with DM, mortality remained significantly lower as well (aOR 0.24, 95% CI 0.22-0.27; P < 0.0001). Conclusion: Gastroparesis with diabetes paradoxically demonstrates superior survival outcomes despite increased comorbidity burden. Diabetic patients experience shorter hospitalizations and reduced healthcare costs. These findings suggest diabetes may confer protective mechanisms or reflect improved disease management strategies. Healthcare resource allocation should consider these differential outcomes. Further research should investigate underlying biological and care delivery factors driving these counterintuitive results.