S2940 Pediatric EoE Admissions Over Time: Insights From a Multicenter Cohort

Introduction: The prevalence of eosinophilic esophagitis (EoE) is increasing, and existing studies of nationally representative databases have reported a rise in charges related to EoE that outpace inflation. These studies are limited in that they are unable to evaluate encounter-level data to accurately describe diagnostic, pharmacologic, and procedural resource utilization during admissions. This study aims to 1) identify trends in EoE-related encounters at hospitals within the Pediatric Health Information System® (PHIS) registry, and 2) identify factors associated with hospital length of stay (LOS). Methods: We conducted a multicenter retrospective cohort study using the PHIS registry, a dataset containing de-identified information on clinical and health resource utilization from 48 children’s hospitals. Patients 0-21 years of age discharged between 1/1/2010-12/31/2024 were eligible. Included hospitalizations for EoE were identified using ICD-9/10 codes for EoE as a principal diagnosis or a secondary diagnosis for EoE with an accompanying principal diagnosis of a prominent symptom of EoE. Our outcomes of interest included rates of hospitalization per 1,000 total encounters at each institution and total hospital LOS in days. The association between hospital LOS for the first eligible encounter for each patient and various demographic and clinical predictors were assessed using multivariate linear regression. Results: Overall, 3,542 individuals were included for study. Hospitalization rates per 1,000 encounters did not increase significantly from 2010-2024. Our cohort was 71% male with a median age of 10 years. Overall, 56% of patients had a hospital LOS of 1 day. Patients were frequently prescribed systemic (41%) or topical/swallowed (32%) corticosteroids and proton pump inhibitors (57%). In our multivariate model, undergoing imaging or fluoroscopic studies were associated with an increased LOS (1.23 days, 95% CI 0.84-1.61). From a procedural standpoint, undergoing endoscopy was associated with prolonged LOS (0.97 days, 95% CI 0.35-1.59). Conclusion: Despite a recognized rise in the prevalence of EoE over time, hospitalization rates remained stable, suggesting that improvements in disease recognition and outpatient management may be mitigating the need for inpatient care. We identified several factors with significant associations as predictors of LOS. Further investigation is needed to understand the relationship between these factors and LOS, as this may reflect efficacy of acute management and severity of illness.