Features that may predict hospital admission following outpatient therapeutic ERCP

Background: Some patients are admitted following outpatient therapeutic ERC P because of adverse events. This study aimed to identify factors that may predict such admissions. Methods: We prospectively studied admissions for post-ERCP adverse events i n 415 consecutive patients undergoing outpatient therapeutic ERCP. potentia lly relevant predictors of admission were assessed by univariate analysis a nd in case of significance included in a multivariate analysis. Results: Admission was necessary in 41 patients (9.9%) because of complicat ions and in 63 (15.2%) for observation of adverse events that did not progr ess to definable complications. Potential predictors of admission were eval uated comparing patients who required more than an overnight admission (n = 63) with those who did not (n = 352). Multivariate analysis identified thr ee factors that were significant: pain during the procedure (odds ratio 3.8 : 95% CI [1.8, 7.9]), history of pancreatitis (odds ratio 2.3: 95% CI [1.1, 4.7]) and performance of sphincterotomy (odds ratio 2.2: 95% CI [1.1, 4.3]) . The presence of all these features was associated with a 66.7% likelihood of admission, whereas the absence of pain during the procedure, history of pancreatitis and performance of sphincterotomy made admission likely in on ly 11.0%, 9.8% and 10.7%, respectively, of the cases. Conclusions: The occurrence of pain during the procedure, a history of panc reatitis and the performance of sphincterotomy were independent predictors of admission following outpatient therapeutic EWCP.