Tu1131 TRENDS OF EOSINOPHILIC ESOPHAGITIS IN THE US INPATIENT POPULATION Shantanu Solanki, Khwaja F. Haq, Muhammad Ali Khan, Vinshi N. Khan, Smit Patel, Uvesh Mansuri, Shalom Frager, Sachin Sule, Edward Lebovics Introduction Eosinophilic esophagitis (EoE) is characterized as an allergic inflammatory condition with eosinophilic infiltration of the esophageal tissue resulting in stiffening or narrowing of the esophagus, which can lead to dysphagia or food getting stuck in the esophagus. While EoE was previously thought to be a rare disease, it has recently been recognized as one of the most common causes of dysphagia and food impaction in young adults. Limited epidemiological data exists on the annual number of hospitalizations, demo- graphic variation, cost of care and outcomes for patients hospitalized with EoE. Methods We analyzed the National Inpatient Sample (NIS) database for all subjects with discharge diagnosis of EoE (ICD-9 code 530.13) as primary or secondary diagnosis during the period from 2008-2012. NIS is the largest publicly available all-payer inpatient care database in the US containing data from approximately 8 million hospital stays per year. Statistical significance of variation in the number of hospital discharges, patient demographics, cost of care, and outcomes was determined using Cochran-Armitage trend test. Results In 2008, there were 566 hospitalizations with discharge diagnosis of EoE as compared to 4,620 in 2012 (p<0.0001, figure 1A). From 2008 to 2012, EoE remained most common in the age groups 18-34 (p=0.0013) and 35-49 (p=0.0006) when compared to all other groups (figure 1B). We also found a male preponderance, with no significant change in trend from 2008 to 2012 (p=0.2369, figure 1C). Additionally, from 2008 to 2012, racial predilection was evident with white race being at highest risk for hospitalization with EoE (p=0.2805, figure 1D). Southern hospitals had the highest (p=0.0042) whereas northeastern hospitals had the lowest (p<0.0001) discharge diagnosis of EoE from 2008-2012 (figure 2A). Although overall inpatient mortality associated with discharge diagnosis of EoE was low and continued to decreased from 0.83% in 2008 to 0.22% in 2012 (p=0.0163, figure 2C), mean length of stay (LOS) and cost of care per hospitalization increased significantly from 3.6 to 4.7 days (p<0.0001, figure 2B) and $8,548 to $11,119 (adjusted for inflation, p<0.0001, figure 2D) respectively. Discussion A significant rise in the annual number of hospitalizations with EoE was found with young adults being most commonly affected. Increase in hospitalization could possibly be due to improved recognition of the condition by healthcare providers as well as advancement in detection techniques. EoE has low overall inpatient mortality, however, trends from our study showed cost of care and mean LOS associated with this diagnosis both significantly increased over the last few years. Further studies are needed to identify factors responsible for such results as well as predictors of increasing number of hospitalizations with eosinophilic esophagitis. S-873 AGA Abstracts Figure 1 Figure 2 Tu1132 PREVALENCE OF ESOPHAGEAL EOSINOPHILIA IN FIRST DEGREE RELATIVES OF EOSINOPHILIC ESOPHAGITIS PATIENTS John C. Fang, Fred Clayton, Linda J. Taylor, Darcie Gorman, Angela Presson, Kathryn A. Peterson INTRODUCTION Eosinophilic esophagitis (EoE) is a chronic inflammatory and immune- mediated disease of eosinophil infiltration. EoE may have a genetic basis which has yet to be fully defined. Multiple cases of familial clustering of EoE have been described. The prevalence of EoE in first degree family members has not been reported. AIM To determine the prevalence of esophageal eosinophilia (EE) in 1st degree adult relatives (FDR's) of EoE patients. METHODS Index EoE subjects were identified and their FDR's (parents, siblings, children) were invited to participate. Family trees were constructed of index EoE patients and their FDR's. FDR's underwent EGD with biopsies of proximal and distal esophagus and filled out validated questionnaires for GERD, dysphagia and allergy/atopy. Index EoE patient's were diagnosed by standard criteria of esophageal symptoms, esophageal eosinophilia (> 15 eos/hpf ) and PPI non-responsiveness. Study subjects (i.e. FDRs) were diagnosed by esopha- geal eosinophilia (>15 eos/hpf). However, PPI responsive esophageal eosinophilia was not ruled out due to logistical reasons. RESULTS A total of 41 families of index EoE patients participated. Family trees showed a total of 236 eligible (> age 18, living) FDR's of the 41 index EoE patients. 81/236 (34.5%) FDR's were enrolled and underwent endoscopy. 24/81 (30%) of enrolled FDR's had significant esophageal eosinophilia. The mean proximal and distal eos/hpf were16 ±13.3 and 28.8 ± 11.5 for the FDR's with esophageal eosinophilia compared to 0.7 ± 2.4 and 1.2 ± 2.4 eos/hpf for the FDR's without esophageal eosinophilia (p<0.001 for both proximal and distal eos/hpf ). Significantly more male FDR's had EE 16/40 (40%) compared to female FDR's 8/41(20%) (p=0.04).Dysphagia score was also significantly higher in FDR's with EE, but there was no difference in incidence of asthma, GERD and food allergy between FDR's with and without EE. See Table 1. The incidence of EE in parents, siblings and parents of EoE patients ranged from 9-73% with the highest incidence in sons (73%) and the lowest in daughters (9%). See Table 2. CONCLUSIONS The prevalence of esophageal eosinophilia is high and male predominant in first-degree relatives of EoE patients. There is a significantly higher incidence of EE in male FDR's compared to other female FDR's of EoE patients. Symptoms of dysphagia GERD, and food allergy are also high in FDR's of EoE patients. These results suggest there may be a genetic and/or shared environmental component to esophageal eosinophilia and EoE . AGA Abstracts