S1223 Burden of Gastrointestinal and Systemic Comorbidities in Patients Diagnosed With GIST During EGD: A Multi-Center Propensity-Matched Study

Introduction: Gastrointestinal stromal tumors (GISTs) are uncommon subepithelial tumors often detected incidentally during upper endoscopy. The broader clinical burden of GIST, particularly in relation to gastrointestinal, metabolic, and cardiovascular comorbidities, remains unclear. We aimed to characterize the prevalence of key comorbid conditions among patients diagnosed with GIST during esophagogastroduodenoscopy (EGD) compared to matched controls without GIST. Methods: This is a retrospective, multi-institutional cohort study, conducted using the TriNetX research network, which aggregates real-time electronic medical records from over 100 healthcare organizations. Adult patients (≥18 years) who underwent esophagogastroduodenoscopy (EGD) between October 1, 2015, and October 1, 2024, were included. The exposure cohort comprised patients diagnosed with (GIST) within 1 year of EGD. The control cohort included patients with no GIST diagnosis during the same period. 1:1 propensity score matching was performed based on age, sex, race, and ethnicity, yielding 2,143 patients per group. Baseline prevalence of gastrointestinal, metabolic, cardiovascular, and systemic conditions was assessed using structured diagnosis codes. Between-group differences were evaluated using 2-sided statistical tests, with significance defined as P < 0.05. Results: Following propensity score matching, demographic characteristics were well-balanced between the GIST and non-GIST groups (n = 2,143 each). The mean age was 65.0 ± 13.2 years in the GIST group and 64.1 ± 14.9 years in the non-GIST group, with 53.1% female and 58.6% White in both cohorts. GIST patients had higher rates of several upper GI disorders, including GERD, gastritis/duodenitis, peptic ulcers, and constipation. Conversely, patients without GIST were more likely to have systemic comorbidities such as diabetes, hyperlipidemia, hypertension, ischemic heart disease, cerebrovascular disease, and chronic kidney disease. Conclusion: Patients diagnosed with GIST during EGD exhibit a higher burden of upper gastrointestinal disorders at baseline, while non-GIST patients have a greater prevalence of systemic cardiometabolic conditions. These distinct comorbidity patterns may inform risk stratification and long-term management strategies following incidental GIST detection during endoscopy.