Presentations to United States emergency departments for gastroparesis, cyclic vomiting, and cannabinoid hyperemesis syndrome from 2016 to 2024.

INTRODUCTION

Gastroparesis (GP), cyclic vomiting syndrome (CVS), and cannabinoid hyperemesis syndrome (CHS) are chronic disorders of gut-brain motility. Though GP, CVS, and CHS are relatively common, recent, large scale data on their incidence and acute management are lacking. Thus, we sought to assess the incidence, rates of admission, medication administrations, and demographic data among emergency department (ED) visits for GP, CVS, and CHS in the United States.

METHODS

This was a retrospective cohort study of all ED presentations for GP, CVS, and CHS from 1/1/2016 to 12/31/2024 in the Epic Cosmos database. Emergency department visits for adults with GP, CVS, and CHS were identified by ICD-10 codes. Outcomes included incidence, admission rates, medications administered, and hospital length of stay (LOS). Data were analyzed using descriptive statistics and compared using multilevel chi-squared tests.

RESULTS

Out of 248,293,507 ED encounters over a nine-year period from 2016 to 2024, there were 165,857 (0.07 %), 204,636 (0.08 %), and 134,059 (0.05 %) encounters with an ICD-10 code corresponding to GP, CVS, and CHS, respectively. Gastroparesis and CVS were most prevalent in the southern United States; CVS was equally prevalent in the South and the Midwest. All three conditions primarily affected females. The mean age of patients with GP, CVS, and CHS is 44.7 years, 36.5 years, and 32 years, respectively. Mean admission rates for patients with GP and CHS remained steady over the nine-year period at approximately 25.4 % and 13.5 %, respectively. Admission rates for patients with CVS dropped from 20.3 % in 2016 to 11.5 % in 2024. The mean LOS for GP, CVS, and CHS were 5.8, 4.7, and 3.8 days, respectively. For all conditions, ondansetron was the most commonly administered medication (61.3 % for GP, 63 % for CVS, and 58.7 % for CHS). For GP and CVS, the second most commonly administered medication was metoclopramide (48.2 % and 27.4 %, respectively). For CHS, the second most commonly administered medication was haloperidol (32.6 %).

CONCLUSION

Gastroparesis, CVS, and CHS are common reasons for presentation to the ED. Ondansetron remains the most common treatment for acute exacerbations of GP, CVS, and CHS. Rates of admission and hospital LOS for all three conditions demonstrate that GP, CVS, and CHS continue to pose a significant burden on healthcare systems.