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Gastrointestinal Endoscopy and the Risk of Prosthetic Joint Infection: A Nationwide Database Analysis

Wang, Yichen; Zhang, Wei; Chen, Bing; Huang, Xiaoquan; Li, Si; Huang, Yuting; Bansal, Pardeep
BACKGROUND:Current guidelines suggest antibiotics prophylaxis is not necessary for patients with orthopedic prosthetics undergoing gastrointestinal endoscopy. Clinical evidence to support this recommendation is lacking. AIMS/OBJECTIVE:To analyze the association between inpatient gastrointestinal endoscopy and prosthetic joint infection (PJI) in patients with a recent arthroplasty. METHODS:We included patients admitted from July to October of each calendar year (index admissions) who had an arthroplasty in the same calendar year prior to the index admission. We followed the occurrence of PJI for 60 days after the index admission. Only admissions from July to October were chosen as index admissions, and the follow-up period was limited to 60 days because the database structure prohibits the analysis of events in different calendar years. We compared the rate of 60-day PJI between those who had gastrointestinal endoscopy on index admissions to those who had not. We excluded patients aged less than 18 years, who died on index admission, or had any infection in the same calendar year before or during the index admission. RESULTS:Of 1,831,218 patients with arthroplasty, 88,345 met the inclusion criteria, out of which 5,855 had gastrointestinal endoscopy. The rate of 60-day PJI in those who had endoscopy was 0.23%, and in those who had not was 0.52% (P < 0.001). EGD without excision (adjusted odds ratio [95% confidence interval]: 0.20 [0.03-1.42], P = 0.107), EGD with excision (0.58 [0.21-1.60], P = 0.295), colonoscopy without excision (0.43 [0.11-1.72], P = 0.233), colonoscopy with excision (0.31 [0.04-2.21], P = 0.241), and PEG/PEJ (0.38 [0.05-2.71], P = 0.337) were not associated with risk of 60-day PJI. We found no PJI cases in patients underwent esophageal dilation, ERCP, and EUS with FNA. CONCLUSIONS:Gastrointestinal endoscopy in hospitalized patients with a recent previous arthroplasty is not associated with an increased risk of 60-day prosthetic joint infection.
PMID: 35384622
ISSN: 1573-2568
CID: 5201632

Morbid obesity but not obesity is associated with increased mortality in patients undergoing endoscopic retrograde cholangiopancreatography: A national cohort study

Chen, Bing; Yo, Chia-Hung; Patel, Ramya; Liu, Bolun; Su, Ke-Ying; Hsu, Wan-Ting; Lee, Chien-Chang
BACKGROUND:The relationship between body weight and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) is unclear. OBJECTIVES:This study aimed to investigate the impact of obesity and morbid obesity on mortality and ERCP-related complications in patients who underwent ERCP. METHODS:We conducted a US population-based retrospective cohort study using the Nationwide Readmissions Databases (2013-2014). A total of 159,264 eligible patients who underwent ERCP were identified, of which 137,158 (86.12%) were normal weight, 12,522 (7.86%) were obese, and 9584 (6.02%) were morbidly obese. The primary outcome was in-hospital mortality. The secondary outcomes were the length of stay, total cost, and ERCP-related complications. Multivariate analysis and propensity score (PS) matching analysis were performed. The analysis was repeated in a restricted cohort to eliminate confounders. RESULTS:Patients with morbid obesity, as compared to normal-weight patients, were associated with a significantly higher in-hospital mortality (hazard ratio [HR]: 5.54; 95% confidence interval [CI]: 1.23-25.04). Obese patients were not associated with significantly different mortality comparing to normal weight (HR: 1.00; 95% CI: 0.14-7.12). Patients with morbid obesity were also found to have an increased length of hospital stay and total cost. The rate of ERCP-related complications was comparable among the three groups except for a higher cholecystitis rate after ERCP in obese patients. CONCLUSIONS:Morbid obesity but not obesity was associated with increased mortality, length of stay, and total cost in patients undergoing ERCP.
PMCID:8259364
PMID: 33951338
ISSN: 2050-6414
CID: 5046132

Use of Fully Covered Self-Expanding Metal Stents for Management of Choledocholithiasis: A Systematic Review and Meta-Analysis

El Halabi, Maan; Chen, Bing; Gold, Christopher A; Walsh, Rose; Ichkhanian, Yervant; Uberoi, Angad; Kumta, Nikhil A
ORIGINAL:0015362
ISSN: 1572-0241
CID: 5046522

OUTCOMES OF ATRIAL FIBRILLATION/FLUTTER PATIENTS HOSPITALIZED FOR LOWER GASTROINTESTINAL BLEEDING: RESULTS OF A NATIONAL COHORT [Meeting Abstract]

Xie, Mengdan; Chen, Bing
ISI:000656222900215
ISSN: 0016-5107
CID: 5046302

Does Intravenous Bicarbonate Improve the Acid-Base Balance and Prevent Kidney Injury in Mild Metabolic Acidosis? [Meeting Abstract]

Mahmoud, O.; Chen, B.; Chakraborti, A.; Salonia, J.
ISI:000556393504153
ISSN: 1073-449x
CID: 5046502

ARE PATIENTS STARVING? A SYNOPSIS ON FASTING TIME IN HOSPITALIZED PATIENTS AND PROPOSAL ON QUALITY IMPROVEMENT [Meeting Abstract]

Zhang, Xiaocen; Chen, Bing; Patel, Ramya; Bsrat, Makda; Kassim Gassan; Patel, Jessica; Markoff, Brian;
ORIGINAL:0015361
ISSN: 1553-5606
CID: 5046492

Diagnosis of a Grave Disease in a Seemingly Asymptomatic Woman: Budd-Chiari With Portal Vein Thrombosis in Setting of Polycythemia Vera [Meeting Abstract]

El Halabi, Maan; Husney, Jack; Chen, Bing; Concepcion, Jose; Ascunce, Gil
ISI:000607196706292
ISSN: 0002-9270
CID: 5046232

Endoscopy for Hospitalized Patients With Atrial Fibrillation Is Safe: Analysis From the 2016 National Impatient Sample [Meeting Abstract]

Chen, Bing; Smith, Michael S.
ISI:000607196701199
ISSN: 0002-9270
CID: 5046182

IS THERE AN OBESITY PARADOX IN PATIENTS UNDERGOING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP), NATIONAL INPATIENT SAMPLE STUDY 2014 [Meeting Abstract]

Chen, Bing; Shah, Suraj; Lee, Chien-Chang
ISI:000545678400727
ISSN: 0016-5107
CID: 5046242

Impact of Treatment with Direct Acting Antiviral Drugs on Glycemic Control in Patients with Hepatitis C and Diabetes Mellitus

Mada, Pradeep Kumar; Malus, Matthew E; Parvathaneni, Arvin; Chen, Bing; Castano, Gabriel; Adley, Sharon; Moore, Maureen; Hieda, Michinari; Alam, Mohammed J; Feldman, Mark; King, John William
Aim/UNASSIGNED:To assess the effect of treating chronic hepatitis C virus (HCV) infection with direct acting antiviral drugs (DAAs) on glycemic control in patients with concomitant diabetes mellitus (DM). Methods/UNASSIGNED:We performed a retrospective case-control study in a viral hepatitis ambulatory clinic in Shreveport, Louisiana, during the period 11/01/2014 to 12/31/2017. All the clinic patient ages 18 years and above with treatment-naïve/biopsy-proven chronic hepatitis C and DM (hemoglobin A1C level ≥ 6.5%) who were eligible for treatment were included in the study. Of 118 such patients, 59 were treated with oral DAAs for 8-12 weeks with the goal of achieving a sustained virologic response (SVR). A control group of 59 patients did not receive treatment for their hepatitis C and was followed in the clinic. Patients in the control group did not receive treatment either due to insurance issues or refusal of hepatitis C treatment. Results/UNASSIGNED:< 0.0001 vs. the treatment group, which had a mean HbA1C decrease of 0.9 ± 0.2%). Conclusion/UNASSIGNED:This controlled study demonstrated that treatment of chronic hepatitis C with DAAs results in statistically significant and meaningful reductions in hemoglobin A1C levels in patients with coexisting diabetic mellitus if a SVR is achieved.
PMCID:7201615
PMID: 32395351
ISSN: 2090-3448
CID: 5046162