Intra- and Post-procedural Patient-reported Experience Measures and their Correlation with post-ERCP Adverse Events and Unplanned Healthcare Utilization.

Background and Study Aims Post-endoscopic retrograde cholangiopancreatography (ERCP) adverse events (AEs) are common, as is unplanned healthcare utilization (UHU). We aimed to elucidate potential associations between intra- and post-procedural patient-reported experience measures (PREMs) and post-ERCP AEs and UHU. Patients and Methods Prospective data from a multi-center collaborative were used. A validated 0-10 Likert-based PREM assessing intra- and post-procedural symptoms was applied to patients following ERCP and protocolized follow-up was performed at 30 days to identify AEs and UHU for reasons not meeting the definitions of any AE. Multivariable logistic regression was conducted using PREM domains as exposures and individual AEs and UHU as outcomes, with a priori selected patient- and procedure-related covariates. Test performance characteristics and odds ratios (ORs) and 95% confidence intervals (95% CIs) for each PREM domain were reported. Results From September 2018 through October 2023, 3,434 ERCPs were included. Post-procedural abdominal pain of >3 was predictive of pancreatitis (OR 3.71, 2.37-5.73), while a score >6 was strongly predictive of perforation (OR 9.54, 1.10-59.37). Post-procedural pain was also predictive of UHU within 30 days when used as a continuous predictor (OR 1.08 per point, 1.01-1.16). Post-procedural pain of >6 demonstrated high negative predictive values and specificities for post-ERCP AEs. Conclusions Patient-reported symptom scores from a simple Likert-based PREM at the time of discharge from ERCP are associated with presentations for pancreatitis, perforation, and UHU within 30 days. Applying PREMs post-ERCP could potentially prevent UHU and/or facilitate earlier management and improved outcomes for patients with post-ERCP AEs.