Endoscopic retrograde cholangiopancreatography-related adverse events and unplanned hospital encounters in patients with underlying depression and anxiety

Endoscopic retrograde cholangiopancreatography (ERCP) is associated with a high risk of adverse events (AEs) and unplanned hospital encounters (UHEs) but the impact of pre-existing depression and/or anxiety is unknown. We aimed to examine this association. We analyzed multi-centre prospective data on adults undergoing ERCP to examine associations between pre-existing anxiety and/or depression and post-ERCP UHEs (any emergency department visit or unplanned admission) within 30 days, separately for reasons related to AEs and for reasons not meeting criteria for AEs. We conducted multivariable logistic regressions to examine associations including relevant covariates. The cohort included 6,648 patients, with 11.8% having pre-existing depression and/or anxiety. The group with depression and/or anxiety was significantly younger, had higher rates of opioid and cannabis use, and had a greater proportion of females. There were no statistically significant differences in non-AE-related UHEs in patients with and without depression/anxiety (5.0% vs 4.1%, respectively, p=0.26), or AEs (7.4% vs 7.7%, respectively, p=0.75). There was no association between depression/anxiety and non-AE UHEs on multivariable modelling (adjusted odds ratio, OR, 1.27, 95% CI 0.86–1.89), including on sub-analysis of UHEs due to somatic symptoms only (OR 0.85, 95% CI 0.47–1.53). Similarly, no association was found between depression/anxiety and AEs (OR 0.85, 95% CI 0.61–1.17). We found no statistically significant associations between pre-existing depression and/or anxiety and ERCP outcomes. Further research is needed to investigate diagnostic classes and symptom severity along with other factors that could impact outcomes. • This was a prospective analysis of adults undergoing ERCP. • There were 6,648 patients, 11.8% with pre-existing depression and/or anxiety. • There were no differences in unplanned health encounters with depression/anxiety. • There were no differences in adverse events.