Outcomes of Gastroparesis in Hospitalized Patients With Generalized Anxiety Disorder

Anna G Mathew; Alexander J Kaye; Shivani J Patel; Sarah R Meyers; Pooja Saiganesh; Weizheng Wang

doi:10.7759/cureus.35832

Outcomes of Gastroparesis in Hospitalized Patients With Generalized Anxiety Disorder

Cureus. 2023 Mar 6;15(3):e35832. doi: 10.7759/cureus.35832. eCollection 2023 Mar.

Authors

Anna G Mathew¹, Alexander J Kaye¹, Shivani J Patel¹, Sarah R Meyers², Pooja Saiganesh¹, Weizheng Wang³

Affiliations

¹ Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA.
² Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, USA.
³ Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA.

Abstract

Background Gastroparesis is a common gastrointestinal pathology that has been increasing in prevalence and represents a significant cost to the United States healthcare system. Gastroparesis is associated with psychological dysfunction, including generalized anxiety disorder (GAD). GAD is known to be a prevalent and chronic manifestation of anxiety, which has been increasing in prevalence since the year 2020. Despite the association between gastroparesis and GAD, there has been limited research on the possible impact GAD may have on the morbidity and mortality of patients hospitalized for gastroparesis, which is further evaluated in this study. Methods Using the Nationwide Inpatient Sample from the year 2014, a retrospective study was conducted to assess the outcomes of hospitalized gastroparesis patients with and without a history of GAD. In this study, the analyzed outcomes included acute kidney injury (AKI), acute respiratory failure, sepsis, acute deep vein thrombosis, myocardial infarction, intestinal obstruction, and inpatient mortality. To assess whether GAD is an independent risk factor for the outcomes, a multivariate logistic regression analysis was used. Results There were 22,150 patients with gastroparesis assessed in this study; GAD was found to be a comorbid diagnosis in 4,196 of those patients. In the GAD cohort, there was an elevated risk for AKI (adjusted odds ratio 1.24, p < 0.001). The adjusted odds ratios for acute respiratory failure, sepsis, acute deep vein thrombosis, myocardial infarction, intestinal obstruction, and inpatient mortality did not meet the threshold for statistical significance. Conclusion In hospitalized gastroparesis patients, GAD is a risk factor for AKI. This finding may be attributed to prerenal azotemia due to an increased risk of nausea and vomiting associated with GAD, as well as the medications used to treat GAD such as escitalopram and duloxetine. In addition, the dual inflammatory states caused by the co-existence of both GAD and gastroparesis may also have a role in increasing the risk for AKI. The results of this study may become increasingly relevant given the increasing prevalence of GAD. .

Keywords: acute renal failure; diabetes mellitus; gastroparesis; generalized anxiety disorder; nausea; vomiting.