increase in mortality following major postoperative complications. These results support the idea that early discharge is safe in the appropriate patient population. Su2025 IMPACT OF POST-OPERATIVE ILEUS AMONG INPATIENTS UNDERGOING GASTROINTESTINAL SURGERIES IN THE UNITED STATES Paul Wischmeyer, Yaozhu J. Chen, Jen Judy, Dorothy Baumer, Scott B. Robinson, George Dukes, Cristina Almansa, David Liska, Conor P. Delaney Background: Post-operative ileus (POI) or prolonged post-operative gastrointestinal (GI) dysfunction is common after GI surgery and is often associated with increased post-surgical complications affecting patients’ quality of life, requiring more healthcare resource utilization, and imposing additional cost pressure on hospitals. This database study evaluates the impact of POI on length of stay (LOS), cost, and discharge among inpatients undergoing GI surgery in the modern era of enhanced recovery and GI-specific opiate antagonist use. Methods: The Premier Healthcare Database (PHD), a nationally representative hospital database in the United States (US) was used to conduct a health outcomes study in patients undergoing GI surgery between Q1 of 2016 and 2019 in hospitals with POI case-reporting. POI was defined via ICD-10 claims (K56.0, K56.7). Unadjusted comparisons were made examining POI vs. non-POI patients for demographic and clinical characteristics, and outcomes including LOS, total cost per hospital stay (in 2018 US$), and discharge status. Adjusted assessments were conducted via Generalized Linear Models (GLMs) to assess impact of various perioperative factors including presence of POI and institution type (e.g., teaching hospital, bed size) on outcome measures of LOS (negative binomial) and cost (gamma distribution). P-value <0.05 was considered statistically significant. Results: Of 605,192 patients with inpatient stays involving bowel and colonic surgeries in 763 US hospitals, 38,341 were identified with POI. Patients experiencing POI were more likely to be male, older, and electively admitted (Table 1). Unadjusted comparisons revealed that patients with POI had a markedly longer LOS (mean 10.9 days, median 8, interquartile range [IQR] 6-13) vs. those without POI (mean 5.9 days, median 4, IQR 2-7), and higher total cost per hospital stay (mean $29,554, median $21,763, IQR $14,874-$34,137) vs. non-POI (mean $19,022, median $13,754, IQR $9,022- $21,694) (all statistically significant; Figure 1). At discharge, patients with POI were more likely to require continued medical care via intermediate care facilities, home healthcare organizations and other providers (39% vs. 25%, p<0.001). Initial adjusted assessments via GLMs (by controlling for gender, age, payor and admission type) found that a POI diagnosis led to an 82% higher likelihood of longer LOS and 53% higher likelihood of an increased per-stay cost. Conclusions: POI remains common in patients having inpatient gastrointestinal surgery, and continues to prolong length of stay, increase hospital cost, and require signifi- cantly more medical services post-discharge. New strategies to prevent and treat POI are urgently needed. Table 1. Demographic, Socioeconomic and Stay Characteristics S-1553 SSAT Abstracts Figure 1. Length of Stay (LOS) and Medical Cost, Median: Non-POI vs. POI Su2026 UNDERSTANDING REASONS FOR LACK OF SURGICAL TREATMENT IN PATIENTS WITH STAGE I-III GASTRIC CANCER Jessica Ward, Jennifer Chuy, Patricia Friedmann, Haejin In Background Surgical resection is a critical component in the management of non-metastatic gastric adenocarcinoma (GC). Studies show that only about 70% of patients diagnosed with stage I-III GC undergo surgery. Using a single institution in-depth chart review, we aimed to understand the reasons why surgery was not performed for patients with non-metastatic GC. Methods Patients with GC diagnosed between 2015-2017 at a single urban academic institution that serves one of the poorest demographics in the US were abstracted. Patients with Stage I-III or un-staged adenocarcinomas or carcinomas that did not receive surgery to eliminate the tumor were identified for review. Patient charts were reviewed for reasons for lack of surgery. Age, sex, Charlson Comorbidity Index (CCI), Eastern Cooperative Oncology Group Performance Score (ECOG), location of the tumor, and stage were examined for each group. Results Of 119 patients with Stage I-III or un-staged cancer, 30 patients (25.2%) did not receive surgery. We discerned 5 primary reasons for no surgical treatment: Not a surgical candidate (n=11/30, 36.7%), expired during chemotherapy (n=4/30, 13.3%), expired prior to any treatment intervention (n=4/30, 13.3%), patient or family chose not to pursue surgery (n=6/30, 20%), and disease progression (n=5/30, 16.7%). Those with disease progression were not further analyzed as no surgery is standard treatment. Of the eleven patients who were not surgical candidates, surgical consultation was obtained in 91% (n=10/11). Two patients had an ECOG of 4, five had a CCI >= 9 and two had both. The remaining two patients had ECOGs of 2 and CCIs of 5 and 7 with advanced cardiac disease and severe cirrhosis with portal HTN being the respective reasons for no surgery. Of the four patients who expired during chemotherapy, all had surgical consultations. Three patients had CCIs >=9. The remaining patient was 72 years old with an ECOG of 1, CCI of 7, and unknown cause of death. Of the four patients who expired prior to any treatment initiation, 50% (n=2/4) had surgical consultation. One patient had an ECOG of 4, two had CCIs >= 9. The remining patient had an ECOG of 2, CCI of 6, and had been scheduled for surgery prior to death of unknown cause. The median age of the six patients who chose not to pursue surgery was 88. Surgical consultation obtained in 33.3% (n=2/6). Five patients had CCIs >= 9, and the remaining patient was 90 years old. Conclusion Overall, it appeared that most, if not all, patients had valid reasons for not receiving surgical intervention including advanced age, multiple comorbidities, and poor performance score. Surgical consultation frequently occurred appropriately in our study. It remains to be seen if this is specific to the academic institution, type of cancer, or is reflective of a wider trend. A larger sample size would be needed to better establish these findings. Su2027 ATYPICAL MYCOBACTERIAL INFECTION A THREAT FOR DEVELOPING COUNTRIES WITH IMPROPER STERILIZATION TECHNIQUES Keyur S. Bhatt, Dhaval Mangukiya Introduction: The non-tuberculous mycobacteria (NTM) have emerged as important oppor- tunistic pathogens in the recent years especially in the era of laparoscopy in developing countries, leading to cases with non-healing postoperative wounds or sinuses on abdominal wall following general or gynecological surgeries. Patients and methods: Twenty-five patients were referred to our unit from Feb 2014 to April 2019 with sinuses discharging pus following surgery, laparoscopy & drainage procedures. After history and examinations all data collected regarding the sterilization techniques used in primary hospital. Patients were evaluated with wound culture-sensitivity, culture for atypical mycobacteria and treated with long term antibiotics after evaluation and sensitivity results. Results: Four patients received full course Anti Tuberculous treatment before we received them. We received the patients after primary insult was a median of 3.5 months following surgery or any intervention. Follow up of all patients were kept with visits and telephonic conversations. The minimum follow up for the last patient was 6 months and to date no patients had developed the recurrence. In the last 2 years, the total duration of treatment was 6 months, Median duration of treatment was 9 months because in the initial period we were giving treatment for 9 to 12 months. Meantime taken for the healing of wounds were 3.72 months. Most common surgery was found to be laparoscopic surgery was-18 patients, open-5 and two following Incision and SSAT Abstracts