Introduction Gastroparesis (GP) is a chronic debilitating gastric motility disorder defined as delayed emptying of the stomach content without mechanical obstruction. It can result in nutritional deficiencies, leading to poor overall outcomes. We assessed the impact of malnutrition on in-hospital outcomes in patients with gastroparesis. Methods Patients with a primary discharge diagnosis of GP between January 2016 and December 2019 were included in the National Inpatient Sample (NIS) database. Data on patient demographics, hospital characteristics, the Charlson Comorbidity Index (CCI), and the etiology of gastroparesis were collected. The association between malnutrition and outcomes, including mortality, deep vein thrombosis (DVT), pulmonary embolism (PE), sepsis, acute kidney injury (AKI), length of stay (LOS), and total hospitalization charges (THC), were analyzed using the multivariate regression model. Results A total of 182,580 patients with gastroparesis were included in the analysis. Patients with gastroparesis and malnutrition had a higher risk of mortality (adjusted odds ratio {aOR}, 3.29; p<0.001), sepsis (aOR, 0.43; p<0.001), DVT (aOR, 2.34; p<0.001), and PE (aOR, 2.68; p<0.001) compared to patients with gastroparesis without malnutrition. No significant difference was noted in the rates of AKI. Patients with malnutrition also had a prolonged LOS (2.96 days; p<0.001) and higher THC ($22,890; p<0.001) compared to patients without malnutrition. Conclusion Gastroparesis patients with malnutrition are at a greater risk of worse outcomes than those without malnutrition. The early identification of malnutrition in gastroparesis patients can predict morbidity and mortality and assist in risk stratification to enhance outcomes. Further studies are encouraged to identify factors associated with malnutrition in gastroparesis and the impact of interventions to prevent and treat malnutrition.

Background

Clinical experience suggests an increased hospitalization rate for alcohol-related hepatitis (AH) in the winter months; however, seasonal variations in the prevalence of hospitalizations for AH have not been described previously. We hypothesized that AH hospitalizations would be higher in the winter months due to the holiday season and increased alcohol sales.

Methods

Patients with primary or secondary discharge diagnosis of AH were included in the study (International Classification of Diseases, Clinical Modification-10th Revision codes K70.4 and K70.1) between January 2016 and December 2019. The primary outcome measure for this study was daily hospitalizations by each month of the year. Secondary outcome measures included the rate of in-hospital mortality associated with AH, for each month.

Results

The highest number of AH-related admissions was reported in July (n = 56,800; 9%), followed by August (n = 55,700; 8.8%) and May (n = 54,865; 8.7%). February had the lowest number of admissions (n = 46,550; 7.37%). The adjusted mortality was highest in December (overall mortality: 9.6%; adjusted odds ratio: 1.29; 95% confidence interval: 1.142 - 1.461; P < 0.0001) and lowest in May (overall mortality rate: 7.7%). No difference was noted between length of stay and total hospitalization cost between months.

Conclusion

Our findings demonstrate that seasonal variations in hospitalizations related to AH do exist across the United States. Regional differences also exist and follow unique patterns. The increase in admissions for AH is in line with other studies suggesting that heavy drinking happens during the warm season. Hospital administrators and other stewards of healthcare resources can use seasonal patterns to guide allocation of resources.