Impact of Long Hospital Stays on Pediatric Gastroparesis Management with Christian Sadaka, MD

At the 2024 Annual North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Meeting in Hollywood, Florida, from November 7 to 9, 2024, HCPLive spoke with Christian Sadaka, MD, from the Children’s Hospital of Philadelphia (CHOP), on his team’s research on the increase of hospital admission and longer hospital stays in pediatric gastroparesis after the COVID-19 pandemic.

The study reported national trends for hospital admissions of pediatric gastroparesis before and after COVID-19, along with admission characteristics, length of stay, and factors affecting the increase in hospital stays. Using the Pediatric Information System database (January 2014 – September 2023), Sadaka and colleagues studied 20,939 pediatric gastroparesis admissions from a total of 42 hospitals.

Monthly admissions significantly increased from before the COVID-19 pandemic to after February 2020 (161 vs 194 admissions per month; P = .002). The mean length of hospital stays over the 10-year study period was 6 (IQR, 4 – 12) days, with no significant change between 2014 and 2023, and factors linked to a longer length of stay was age (< 5 years), anxiety/depression/eating disorders, increased number of chronic comorbid conditions, and malnutrition.

By recognizing factors linked to longer hospital stays in this patient population, Sadaka said the research can help inform precision medicine, resulting in lower admissions and costs.

“At CHOP, we already have an inpatient motility center, and we’ve noticed that, because the patients are being admitted under the care of motility and not general GI, we've been able…to manage them more precisely,” Sadaka said. “We've been able to have a shorter length stay compared to previous years at CHOP, specifically with inpatient mortality center.”

The study showed a lot of patients had comorbid functional dyspepsia and dysautonomia. For those with comorbid functional dyspepsia, Sadaka hopes that body surface gastric mapping will lead to a precise diagnosis. As for those with dysautonomia, he said he hopes managing vagal nerve dysfunction symptoms of dysautonomia will be able to improve gastroparetic symptoms.

“We hope one day to be able to be able to diagnose better and to know the mechanism of development of gastroparesis better, which [we] hope to achieve someday with basic science,” Sadaka said.

References

^{Sadaka, C, Xu, B, Benitez, A, et al. COVID-19 and Its Prolonged Effect in Shaping the Hospitalization of Patients with Gastroparesis. Presented at NASPHGAN 2024 in Hollywood, Florida, from November 7 – November 9, 2024.}