A223 FACTORS ASSOCIATED WITH EUS DIAGNOSTIC YIELD AND ADVERSE EVENT RISK: A LARGE RETROSPECTIVE SINGLE CENTRE STUDY

Maximizing endoscopic ultrasound (EUS) diagnostic yield (DY) and safety is key to providing high quality care, yet the influence of patient and procedure factors on both these outcomes have only been examined using limited sample sizes. We aim to examine factors associated with EUS diagnostic yield and adverse event (AE) risk using a large cohort of patients who underwent a EUS procedure at our centre. A retrospective chart review of EUS procedures performed between 2009 and 2015 at The Ottawa Hospital was conducted. Data regarding patient demographics and details of the lesion, procedure, medications, and DY were collected. All patient ER visits or hospitalizations within 30 days of the EUS procedure were also collected and reviewed. Relation of the hospital encounter (definitely, possibly, and not) to the EUS procedure was established by consensus using pre-defined criteria. 1647 EUS procedures were examined. The median patient age was 64 (IQR, 53–73) years and 50% were female. Of all EUS cases, 105 (6.4%) presented to the ER or were hospitalized; however, only 58 (3.5%) were related to EUS. DY was 78% for EUS-FNA cases only. Rapid on-site evaluation impacted DY (73% vs. 80%, p = 0.02) but not AE risk (p = 0.53). Multivariate analysis of all cases demonstrated performing a FNA (OR 2.1, 95% CI 1.0–4.4) and having anesthesia-guided sedation (OR 3.9, 95% CI 1.8–8.5) was associated with an increased AE risk. DY was associated being a smoker (OR 0.7, 95% CI 0.5–0.9). Upon separating out EUS-FNA procedures only, we found on multivariate analysis that lesions > 3 cm (OR 2.4, 95% CI 1.1–5.3), using anesthesia-guided sedation (OR 3.9, 95% CI 1.3–12.0), and using a P2Y12 inhibitor (OR 7.9, 95% CI 2.5–25.1) was associated with an increased AE risk. Solid lesions (OR 2.0, 95% CI 1.1–3.6) and lesions > 3 cm (OR 1.9, 95% CI 1.2–3.2) were associated with an increased DY. Lesions > 3 cm should be subject to fewer FNA passes to decrease AE risk. EUS procedures on patients who expect to receive anesthesia-guided sedation should be reconsidered. Finally, patients receiving P2Y12 inhibitors should not be subject to FNA, unless their medication is stopped. Table 1. Factors associated with adverse events within 30 days of EUS procedure diagnostic and yield, multivariate analysis. None

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