Background and Aims: Previous studies have reported gender differences in patients with gastroesophageal reflux disease (GERD). These studies have also reported differences based on gender in the rates of complications. In this study, we aim to identify gender disparities in the rates of GERD complications in the United States. Methods: We queried the 2016-2020 National Inpatient Sample database to identify patients with GERD. Patients with eosinophilic esophagitis or missing demographics were excluded. We compared patient demographics, comorbidities and complications based on gender. Multivariate logistic regression analysis was used to identify the impact of gender on complications of GERD. Results: 27.2 million patients were included in the analysis. Out of them, 58.4% of the hospitalized patients with GERD were female. Majority of the women were White (75%), aged>65 years (57.5%) and were in the Medicare group (64%). After adjusting for confounders, females were noted to have lower odds of esophagitis (aOR=0.85, 95%CI: 0.84-0.86, p<0.001), esophageal stricture (aOR=0.95, 95%CI: 0.93-0.97, p<0.001), Barrett‘s esophagus (aOR=0.58, 95%CI: 0.57-0.59, p<0.001) and esophageal cancer (aOR=0.22, 95%CI: 0.21-0.23, p<0.001). Conclusions: Our study confirms the findings of previous literature that females, despite comprising the majority of the study population, had a lower incidence of GERD related complications. Further studies identifying the underlying reason for these differences are required.

Background and Aims: Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition. Associated pathologies for EoE are similar to those with metabolic-dysfunction-associated steatotic liver disease (MASLD). This study assesses whether an association exists between MASLD and EoE. Methods: We used National Inpatient Sample (NIS) 2020 data to identify adult patients. ICD-10 codes were used to identify patients with MASLD and EoE. The relationship between MASLD and EoE was assessed by multivariate analysis after adjusting for confounding factors, such as patient demographics, hospital characteristics, Charlson comorbidity index, obesity, obstructive sleep apnea (OSA), diabetes, hypertension (HTN), hyperlipidemia (HLD), inflammatory bowel disease (IBD), celiac disease (CD), gastroesophageal reflux disease (GERD), smoking, alcohol use, and irritable bowel syndrome (IBS). Results: Out of 26 million patients, 4,820 had a diagnosis of EoE. The majority of the patients were between 18 and 44 years of age (47.82%), male (54.05%), had private insurance (50.1%), and were in the highest income quartile (29.25%). A higher incidence of MASLD was noted in the EoE group than those without (6.1% vs.2.9%, p<0.001). After adjusting for confounding factors, MASLD had 2.38 times higher odds of having EoE (95% CI-1.82-3.11, p<0.001). Other factors noted to be associated with higher odds of EoE included younger age, Caucasian race, IBS, GERD, IBD, and CD. Conclusions: Our study reports a novel finding that MASLD and EoE are associated. Future prospective studies are needed to confirm and understand the clinical significance of this relationship and how one disease affects the other.

Multiple studies have shown that outcomes of various diseases differ by the hospital teaching status. However, not much is known about the effects of hospital teaching status on outcomes of acute pancreatitis (AP). The aim of this study was to identify if there was an effect of hospital teaching status on the outcomes of AP. The National Inpatient Sample (NIS) database was used to identify patients with a discharge diagnosis of AP from 2016 to 2019. Patients were classified according to whether they were admitted to teaching hospitals (TH) or non-teaching hospitals (NTH). Study outcomes were the length of stay (LOS), total hospitalization cost and charge, sepsis, shock, acute kidney injury, ICU admission, and mortality. A total of 1,689,334 patients were included in the study. Of these, 65.06% were in the TH group, while 34.94% were in the NTH group. Patients admitted to TH had a higher incidence of AKI (18.84% vs. 15.79%, p<0.001), shock (4.32% vs. 2.7%, p<0.001), sepsis (4.48% vs. 3.65%, p<0.001), and ICU admissions (4.78% vs. 2.90%, p<0.001) than NTH. Patients admitted to TH also had a higher length of stay (5.82 vs. 4.54 days, p<0.001) and higher hospitalization charges ($47,390 vs. $65,380, p<0.001). The mortality rate in TH was 2.25% compared to 1.5% in NTH (p<0.001). Patients admitted to TH had higher mortality as compared to NTH. While the exact reason for this is unknown, it can be partially explained by a higher incidence of AKI, shock, and sepsis. Furthermore, ICU admissions were higher in TH, indicating higher resource utilization.

Introduction: Liver transplant (LT) recipients are at high risk of infections due to chronic immunosuppression, complex perioperative factors, and preexisting malnutrition. These infections significantly contribute to increased morbidity, mortality, and health care utilization. This study aimed to evaluate the burden and impact of infections on in-hospital outcomes among LT recipients. Methods: We conducted a retrospective analysis using the National Inpatient Sample (NIS) database from 2016 to 2022 to identify LT recipients. Patients were stratified into 2 groups based on the presence of infections. Demographic characteristics, underlying liver disease, liver-related decompensations, comorbidities, and clinical outcomes were analyzed. Multivariate logistic and linear regression models were used to assess the independent impact of infections on outcomes. Results: Among 247,955 LT recipients, 84,660 (34.1%) developed infections during hospitalization. The most frequently observed infections were pneumonia (12.8%), urinary tract infections (10.7%), and skin and soft tissue infections (5.2%). After adjustment for potential confounders, infections were significantly associated with increased odds of in-hospital mortality (adjusted odds ratio: 2.17; 95% CI: 1.93 to 2.43; P < 0.001), prolonged length of stay (adjusted coefficient: 2.34 d; 95% CI: 2.15 to 2.53; P < 0.001), and higher total hospitalization charges (adjusted coefficient: $25,424.53; 95% CI: $22,068.63 to $28,780.42; P < 0.001). Conclusion: Infections remain a common and clinically significant complication in LT recipients, leading to worse hospital outcomes. These findings highlight the importance of early identification, preventive strategies, and optimized management to improve posttransplant outcomes and reduce health care burden.

Introduction: Patients with inflammatory bowel disease (IBD) are at increased risk of developing other autoimmune disorders due to possible shared genetic, environmental, and immunological mechanisms. While autoimmune diseases are frequently observed in patients with IBD, data quantifying their inpatient prevalence and their association with outcomes such as mortality remain limited. Methods: National Inpatient Sample (NIS) 2016–2020 and International Classification of Diseases 10th Version, Clinical Modification (ICD-10-CM) diagnosis codes were used to identify patients with IBD and autoimmune conditions. A multivariate logistic regression analysis to identify an association between various autoimmune diseases and various IBDs was performed. Results: The study population included 141,478,025 patients. An association was found between 24 autoimmune conditions and IBD. Conclusions: Our study identified autoimmune comorbidities that are more prevalent in IBD patients. We found that polymyositis, AIHA, ITP, and thrombotic microangiopathy are associated with a higher risk of in-hospital mortality. Psoriasis and hypothyroidism are associated with a lower risk of in-hospital mortality. Further studies are needed to explore the mechanisms responsible.