P0562 - Gastrointestinal Endoscopy in Incarcerated Patients: A 6-Year Single-Center Experience

Augustin R. Attwell, MD¹, Angela Keniston, RN^2
1University of Colorado Medical School, Denver, CO; ²Denver Health Medical Center, Denver, CO

Introduction: The medical literature related to incarcerated patients, particularly in Gastroenterology, is limited. We aim to review the historical, technical, and therapeutic features of GI endoscopy procedures (GIEPs) on incarcerated patients at our institution and compare them with non-incarcerated patients.

Methods: Data were obtained for patients ages 18 to 99 who underwent GIEP at Denver Health Medical Center over 6 years via query of the endoscopy database. Patients were identified as Correctional Care (CC) based on status at the time of GIEP. A group of age-, gender-, and race-matched, non-incarcerated patients (non-CCs) was chosen randomly from the same study period as controls. Data related to demographics, procedures, indications, medications, findings, interventions, and complications were obtained and analyzed for each group.

Results: During the study period, 440 CCs [336 males, age 44 ± 11 years; 35% Caucasian, 29% Hispanic, 18% African-American] underwent 764 GIEPs (275 colonoscopy, 412 EGD, 30 ERCP, 30 flexible sigmoidoscopy, and 17 EUS) while 450 non-CCs underwent 774 GIEPs as controls. GI bleeding was a more common indication for GIEP in CCs compared with non-CCs, both for colonoscopy (39% vs. 26%, p=0.006) and EGD (59% vs. 48%, p=0.02). Adequate bowel preparation and complete colonoscopy were more common in non-CCs compared to CCs (56% vs. 41%; p=0.0002 and 92% vs. 81%; p< 0.0001, respectively). Mean Midazolam doses for EGD were higher in CCs (4.8mg vs. 4.3mg, p=0.026). Non-CCs were more likely than CCs to have a normal colonoscopy (45% vs. 35%, p=0.01) or colon polyps (38% vs. 28%, p=0.01), whereas CCs were more likely to have varices (24% vs. 9.5%, p< 0.0001) or a foreign body (4% vs. 0.5%) by EGD. CCs were more likely to undergo variceal banding (8 vs. 2.7%, p< 0.0001) or foreign body removal (3% vs. 1%, p=0.006), and non-CCs more likely to undergo biopsy (33% vs. 29%, p< 0.0001) or polypectomy (18% vs. 11%, p=0.0005). Otherwise, the indications, medications, exam duration and completion, findings, interventions, and complications of GIP were similar between the 2 groups.

Discussion: Compared with non-CCs, CCs at a county hospital are more likely to undergo GIEP for urgent indications such as bleeding or foreign body removal, require more sedation, have a poor colon prep, and fewer polyps. Otherwise, CC and non-CC patients fair similarly for GIEP indications, duration, completion, findings, interventions, and complications.



Disclosures:


Augustin R. Attwell, MD¹, Angela Keniston, RN². P0562 - Gastrointestinal Endoscopy in Incarcerated Patients: A 6-Year Single-Center Experience, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.