Impact of Severe Obesity on Healing of Gastric Ulcers; a retrospective single center study.

Summary: IMPACT OF SEVERE OBESITY ON HEALING OF GASTRIC ULCERS, A RETROSPECTIVE SINGLE-CENTER STUDY Society: ASGE Track: Stomach and Small Bowel Disorders Author(s): Syedreza A. Haider2, Ameer A. Haider3, Ahmed Elkheshen4, Mahmoud Hashim5, Fady Salama1, Bahaaeldeen Ismail1 Institution(s): 1. University of Kentucky College of Medicine, St. Louis, MO, United States. 2. Washington University in St Louis, St Louis, MO, United States. 3. Vanderbilt University, Nashville, TN, United States. 4. Texas Tech University, Lubbock, TX, United States. 5. The University of Texas MD Anderson Cancer Center Division of Cancer Medicine, Houston, TX, United States. Introduction: Known risk factors for gastric ulcer (GU) incidence include smoking status, NSAID usage, and H. pylori infection. Obesity is a prevalent public health problem worldwide that might hinder wound healing via oxidative stress and altered vascularity. To date, there are a paucity of studies investigating the effect of excess adipose tissue on delayed GU healing. This retrospective study aims to evaluate the effect of obesity on GU healing in a model accounting for other potential confounders of the healing process. Methods: After reviewing charts of patients that underwent EGD at a tertiary medical center between 2014 and 2019, 124 patients met the inclusion criteria of having endoscopic evidence of GU and a follow-up EGD (FU EGD) within 2 to 26 weeks. Eligible patients were identified by utilizing the ICD codes for gastric ulcers. The primary outcome was ulcer healing categorized as 'healed' and 'not-healed' as determined by endoscopist description in the FU EGD report. Severe obesity was defined as BMI Â 35 kg/m2. Endoscopic, demographic, and clinical variables known to affect GU healing were also extracted. Covariates that might affect ulcer healing were evaluated in a univariate logistic regression model and those with p<0.1 were used to design multivariate logistic regression model to assess the independent effect of obesity on ulcer healing after adjusting for covariates. The duration between initial EGD and FU EGD was entered into the model to account for its variability. Results: Out of the included 124 patients, 25 (44%) were severely obese (mean BMI 41.3). In the severely obese group, 48% of patients demonstrated a healed GU at the FU EGD, compared to 80.8% of the group with BMI< 35.0. There was no statistically significant difference between the groups regarding age, NSAID usage (40.0%, 23.2%), vasculopathy (44%,27.3%), PPI compliance (83.8%, 84%) and smoking (44.0%,25.3%) (table 1). All those with HP after index endoscopy were compliant with treatment. After univariate analysis, severe obesity, NSAID use, and smoking status were included in the multivariate logistic regression model, which showed significantly lower OR of healed ulcer in severely obese patients (0.22 [95% CI, 0.07-0.65]) (Table 2). Conclusion: Severe obesity was independently associated with delayed GU healing. This suggests a benefit of weight management in a severely obese patient population with GU. Further studies with larger samples and prospective design are required to validate our findings. IMPACT OF SEVERE OBESITY ON HEALING OF GASTRIC ULCERS, A RETROSPECTIVE SINGLE-CENTER STUDY Syedreza Haider DDW ePoster Library. Haider S. 05/24/2022; 355339; Tu1175 user