Evidence map›Paper›PMID 42223540›Full record

ArticleDigestive diseases and sciences2026

High-Risk Comorbidities Drive Adverse Inpatient Outcomes After ERCP: A National Analysis and Predictive Model.

Zachary D Leslie, Khalid Ahmed, Yasmin Ali, Eric S Wise, Nabeel Azeem, Martin Freeman, Stuart K Amateau, Ahmed Dirweesh

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In one paragraph

Article in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Zachary D LeslieCarleton College, Northfield, MN, USA.
Khalid AhmedDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St SE, Minneapolis, MN, 55455, USA. khalidhashim00@gmail.com.
Yasmin AliDepartment of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Eric S WiseDepartment of Surgery, University of Minnesota, Minneapolis, MN, USA.
Nabeel AzeemDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St SE, Minneapolis, MN, 55455, USA.
Martin FreemanDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St SE, Minneapolis, MN, 55455, USA.
Stuart K AmateauDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St SE, Minneapolis, MN, 55455, USA.
Ahmed DirweeshDepartment of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St SE, Minneapolis, MN, 55455, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsPatients undergoing ERCP with chronic kidney disease (CKD), congestive heart failure (CHF), or liver cirrhosis (LC) often experience worse outcomes. It is unclear whether these are driven by procedure-related events or underlying comorbidity.

methodsWe analyzed the National Inpatient Sample to identify adult ERCP cases. High-risk comorbidities were defined as CKD, CHF, or LC. Primary outcomes were inpatient mortality and morbidity.

resultsAmong 1,171,973 ERCP admissions, 267,739 (22.8%) were high-risk. Compared with lower-risk patients, high-risk patients had higher inpatient mortality (3.8% vs 0.8%, P < 0.001) and morbidity (71.8% vs 35.7%, P < 0.001). They also had longer LOS (8.5 vs 5.3 days, P < 0.001) and higher charges ($122,635 vs $81,984, P < 0.001). In adjusted models, high-risk comorbidities independently predicted mortality (OR 3.80, 95% CI 3.66-3.94) and morbidity (OR 3.22, 95% CI 3.18-3.26). LC was the strongest predictor of mortality (OR 4.53), while CHF was most associated with morbidity (OR 2.84). Predictive models showed good discrimination (AUC 0.76 for mortality; 0.73 for morbidity).

conclusionsHigh-risk comorbidities are present in nearly one-quarter of ERCP admissions and strongly predict worse inpatient outcomes. Most adverse events are likely driven by underlying illness rather than ERCP-specific complications. Our validated predictive models may inform counseling, triage, and peri-procedural management.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeHeart FailureLiver CirrhosisRenal Insufficiency, ChronicAdultAgedComorbidityFemaleHospital MortalityHumansLength of StayMaleMiddle AgedRisk AssessmentRisk FactorsUnited StatesChronic kidney diseaseCongestive heart failureEndoscopic retrograde cholangiopancreatographyERCP outcomesHigh-risk comorbiditiesLiver cirrhosisMorbidityMortalityNational inpatient samplePredictive modelingRisk stratification

Identifiers

PMID42223540
PMCPMC13558317

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