Major cardiac events can complicate endoscopic procedures. However, the true incidence and outcomes of these events are not well defined. We aimed to define the true incidence of cardiac arrest during inpatient endoscopic procedures and the associated outcomes. We performed a cross-sectional retrospective analysis of the National Inpatient Sample from 2016 to 2023. Endoscopic intraprocedural cardiac arrests were identified using ICD-10 diagnostic and procedural codes. Multivariable logistic regression was used to assess patient and procedural factors associated with cardiac arrest. Outcomes among patients experiencing endoscopic intraprocedural cardiac arrest were compared with those of all other cases of in-hospital cardiac arrest. Among 11,137,008 inpatient endoscopic procedures, 1,110 were complicated by cardiac arrest, corresponding to one cardiac arrest per 10,125 procedures. Among assessed patient factors, congestive heart failure had the strongest association with cardiac arrest (aOR = 2.78, 95% CI 2.04–3.78; p < 0.001). Compared with upper endoscopy, colonoscopy was associated with a lower risk of cardiac arrest (aOR = 0.50, 95% CI 0.36–0.69; p < 0.001), while endoscopic retrograde cholangiopancreatography had a similar risk (aOR = 0.75, 95% CI 0.49–1.15; p = 0.183). In-hospital mortality was lower among patients with endoscopy-associated cardiac arrest compared with other cases of in-hospital cardiac arrest (30.6% vs. 71.0%; aOR-0.17, 95% CI 0.13–0.23; p < 0.001). Intraprocedural cardiac arrest is an uncommon complication of inpatient endoscopy. Upper endoscopy carries a higher risk than colonoscopy, and patients with congestive heart failure are at increased risk. Outcomes following endoscopy-associated cardiac arrest are more favorable than for other in-hospital cardiac arrests.
Goble et al. (Sat,) studied this question.