Students Research in Progress
Sunday, October 13, 2024
12:45 PM–02:15 PM
Abstract
Introduction:
Portal hypertension is the most frequent complication of advanced cirrhosis. Due to blood flow resistance, patients with portal hypertension commonly develop esophageal varices (EV) which have the potential to rupture and bleed. These patients are at high risk for developing infection, and recent guidelines recommend prophylactic antibiotics as part of the treatment for EV bleed (EVB).
Research Question or Hypothesis:
The purpose of our study is to determine if routine use of prophylactic antibiotics impacts secondary infection(s) rate (primary outcomes), morbidity, mortality, and rebleeding rates (secondary outcomes) in patients presenting with EVB.
Study Design:
This is an IRB approved, retrospective, case-control study evaluating patients admitted to three Los Angeles County Department of Health Services (DHS) facilities (Harbor-UCLA Medical Center, Los Angeles General Medical Center, Olive View-UCLA Medical Center) from 2022-2023.
Methods:
Electronic medical records (EMR) with ICD-9/10 codes for EVB were utilized to determine if patients met study inclusion criteria (age =18 with discharge diagnosis of advanced cirrhosis or EVB who received prophylactic antibiotics during hospitalization). Patients were excluded if they were transferred to non-DHS facilities, discharged from ED, had ascites requiring antibiotic(s) for SBP, on antibiotics upon admission, or had EV secondary to pulmonary vein-thrombosis. Study outcomes will be stratified by antibiotic duration (24-72 hours, >72-144 hours, or =144 hours).
Results:
Data analysis will be performed for each study outcome using descriptive statistics, Chi-square, Fisher exact test, and factorial ANOVA, as appropriate. We will determine the rate of infections (pneumonia, UTI, bacteremia, SBP), hospital length of stay, readmission, and mortality within thirty days after initial EVB related discharge, based on antibiotic(s) duration. Data collection is ongoing and will be analyzed using Prism.
Conclusion:
Pending due to the research-in-progress nature of this abstract.
Presenting Author
Anthony Guevara PharmD CandidateWestern University of Health Sciences
Authors
Patrick Chan Pharm.D., PhD
Shaun Chandna DO
Olive View-UCLA Medical Center
Daniel Huynh PharmD Candidate
Western University of Health Sciences
Arthur Jeng MD
Olive View-UCLA Medical Center
Brian Kim PharmD.
Olive View-UCLA Medical Center
Jignesh Patel PharmD., B.Sc.
Western University of Health Sciences
Anna Pham Pharm.D.
Western University of Health Sciences
Parker Sin PharmD Candidate
Western University of Health Sciences