Abstract
BACKGROUND AND AIMS: Gastroparesis, characterized by delayed gastric emptying, leads to debilitating gastrointestinal symptoms and often experience comorbid psychiatric disorders, possibly linked to brain-gut network dysfunction. This adversely affects quality of life and necessitates medical care. We aimed to characterize the longitudinal impact of comorbid anxiety, depression, or bipolar disorder on health-care resource utilization in adults hospitalized primarily with gastroparesis. METHODS: A retrospective observational study using the 2016-2019 National Inpatient Sample Healthcare Cost and Utilization Project identified patients aged ≥18 years hospitalized with an index diagnosis of gastroparesis (International Classification of Diseases-10 code K31.84). The cohort was stratified based on the presence of comorbid psychiatric mood disorders (depression, anxiety, and bipolar spectrum disorders). We compared the frequency of computed tomography (CT) imaging, gastric emptying studies, endoscopic procedures, length of stay, and hospitalization costs. Chi-square and analysis of variance tests were used. RESULTS: Of 47,265 patients hospitalized with gastroparesis, 21,545 (45.6%) had comorbid psychiatric mood disorders. These patients had a higher mean Elixhauser comorbidity index (3.6 ± 1.8 vs 2.9 ± 1.8, P < .001) and a longer median hospital stay (4, interquartile range: 2-6 vs 3, interquartile range: 2-6, P < .001). Adjusted analysis showed higher CT imaging frequency in this group (adjusted Odds ratio: 1.15; 95% confidence interval: 1.04-1.67). Although the frequency of endoscopic procedures, gastric scintigraphy, and total hospitalization costs were higher in the psychiatric comorbidity group, these differences were not statistically significant in univariable analysis. CONCLUSION: Nearly 50% of gastroparesis patients had concurrent psychiatric disorders and underwent more frequent CT imaging and had longer hospital stays. This underscores the importance of screening all gastroparesis patients for psychiatric disorders upon admission and exploring the effectiveness of incorporating psychosocial interventions into the treatment plan for gastroparesis patients.