P0598 - A Retrospective Cohort Study: Utility of Fecal Occult Blood Test in the Acute Hospital Setting and Its Clinical Impacts

Jin Tao, MS, MD¹, Luqman Baloch, MD², Naser Khan, MD², Altaf Dawood, MD, MBBS^2
1MercyHealth, West Dundee, IL; ²MercyHealth, Rockford, IL

Introduction: The utilization of fecal occult blood test (FOBT) beyond colorectal cancer (CRC) screening is often questionable. Despite this, FOBT is being used for reasons such as gastrointestinal (GI) bleed and/or anemia which highlights the potential for FOBT to influence inappropriate clinical decision making. We aim to evaluate practice trends in utilizing FOBT in acute hospital setting and its impact on affecting clinical management of GI bleed and/or anemia.

Methods: A retrospective cohort study of adult patients admitted for GI bleed and/or anemia during inpatient hospital stay at a large suburban hospital was completed from 01/01/2020 to 01/01/2022. Patient population were studied in FOBT performed vs. no FOBT performed. The impact of FOBT on endoscopy was assessed as primary outcome. The length of stay & the time until scope were evaluated as secondary outcomes. The p-values are derived from a <em>Chi-square test</em>.

Results: 3257 patients were admitted for concerns of GI bleed and/or anemia between 01/01/2020 and 01/01/2022 (Table 1). Of these patients, 372 FOBTs were performed (FOBT). 109 of the FOBT group underwent endoscopy. 2855 patients admitted for concerns of GI bleed and/or anemia did not have FOBT performed (No FOBT). 785 of the No FOBT group underwent endoscopy. There was no statistical significance between the FOBT group and No FOBT group in endoscopies performed (p-value 0.66). Therefore, there is no utility in having the FOBT done. The average length of stay for FOBT group was 9 days (vs 5.1 days in No FOBT). The difference between these two lengths of stays is statistically significant (p-value < 0.01). The average time until scope for FOBT group was 3.9 days (vs 1.7 days in No FOBT). The difference between these two lengths of stays is statistically significant (p-value < 0.01).

Discussion: Inappropriate utilization of FOBT in the inpatient setting is common, even when the indication does not support its use. Our study shows that FOBT use did not impact the likelihood of endoscopy procedures when considering GI bleed and/or anemia. Instead, FOBT use was associated with longer length of stay and delay in time to endoscopy. Setting limitations on inpatient FOBT may reduce the inappropriate utilization of inpatient FOBT. Quality improvement initiatives are needed to educate clinicians on the appropriate use of FOBT, which is primarily for average risk CRC screening.



Disclosures:


Jin Tao, MS, MD¹, Luqman Baloch, MD², Naser Khan, MD², Altaf Dawood, MD, MBBS². P0598 - A Retrospective Cohort Study: Utility of Fecal Occult Blood Test in the Acute Hospital Setting and Its Clinical Impacts, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.