Incidence of Non-variceal Upper Gastrointestinal Bleeding Worsens Outcomes with Acute Coronary Syndrome: Result of a National Cohort.
Acute Coronary Syndrome
/ complications
Aged
Embolization, Therapeutic
/ statistics & numerical data
Endoscopy, Digestive System
/ statistics & numerical data
Female
Hematemesis
/ epidemiology
Hospital Mortality
Hospitalization
/ economics
Humans
Incidence
Length of Stay
/ statistics & numerical data
Male
Non-ST Elevated Myocardial Infarction
/ complications
Retrospective Studies
Risk Assessment
/ methods
United States
/ epidemiology
Upper Gastrointestinal Tract
/ blood supply
Acute coronary syndrome
Non-ST elevation myocardial infarction
Non-variceal bleeding
ST-elevation myocardial infarction
Unstable angina
Upper gastrointestinal bleeding
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
06
12
2019
accepted:
10
04
2020
pubmed:
25
4
2020
medline:
19
8
2021
entrez:
25
4
2020
Statut:
ppublish
Résumé
Upper gastrointestinal bleeding (UGIB) is a feared complication of acute coronary syndrome (ACS) and has been shown to increase morbidity and mortality. Our aim was to assess the incidence of non-variceal UGIB in patients with ACS in a national cohort and its impact on in-hospital mortality, length of stay (LOS), and cost of hospitalization. This was a retrospective cohort study analyzing the 2016 Nationwide Inpatient Sample (NIS) utilizing ICD 10 CM codes. Principal discharge diagnoses of ACS (STEMI, NSTEMI, and UA) in patients over 18 years old were included. Non-variceal UGIB with interventions including endoscopy, angiography, and embolization were also evaluated. Primary outcome was the national incidence of concomitant non-variceal UGIB in the setting of ACS. Secondary outcomes included in-hospital mortality, length of stay, and cost of stay. A total of 661,404 discharges with principal discharge diagnosis of ACS in 2016 were analyzed. Of the included cohort, 0.80% (n = 5324) were complicated with non-variceal UGIB with increased frequency in older patients (OR 1.03, 95% CI 1.03-1.04; p = 0.0001). Despite endoscopic evaluation, 17.35% (n = 744) underwent angiography. After adjustment of confounders, inpatient mortality was significantly higher in patients with UGIB (OR 2.07, 95% CI 1.63-2.63, p = 0.0001). Non-variceal UGIB also led to significantly longer LOS (10.38 days vs 4.37 days, p = 0.0001) and cost of stay ($177,324 vs $88,468, p = 0.0001). Our study shows that the national incidence of non-variceal UGIB complicating ACS is low at less than 1%, but resulted in significantly higher inpatient mortality, LOS, and hospitalization charges.
Identifiants
pubmed: 32328894
doi: 10.1007/s10620-020-06266-7
pii: 10.1007/s10620-020-06266-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
999-1008Références
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