Trends of Readmissions for Gastrointestinal Bleeding After Alcoholic Hepatitis: Analysis of the Nationwide Readmission Database.
Alcoholic hepatitis
Gastrointestinal bleeding
Readmission
Trends
Journal
Gastroenterology research
ISSN: 1918-2805
Titre abrégé: Gastroenterology Res
Pays: Canada
ID NLM: 101519422
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
06
04
2022
accepted:
12
05
2022
entrez:
15
7
2022
pubmed:
16
7
2022
medline:
16
7
2022
Statut:
ppublish
Résumé
Alcohol consumption is associated with numerous hepatic manifestations, including alcoholic fatty liver disease, alcoholic hepatitis (AH), and liver cirrhosis. AH is a common and serious complication of alcohol use. Gastrointestinal bleeding (GIB) remains one of the most common causes of death in these patients. In this article, we studied the trends of GIB after AH. This was a retrospective interrupted trend study. We analyzed the 2010, 2012, 2014, 2016, and 2018 Nationwide Readmission Databases. The first AH hospitalization in the year was marked as index hospitalization. We identified subsequent hospitalizations with GIB within 30 days and marked them as readmissions. A multivariate regression analysis was used to calculate the risk-adjusted odds of trends for GIB readmissions, including esophageal varices bleeding (EVB), upper GIB, lower GIB, and all GIB. The volume of index hospitalizations increased from 10,248 in 2010 to 16,479 in 2018. Similarly, all readmissions increased from 1,838 in 2010 to 3,908 in 2018. Of all readmissions, EVB increased from 3.9% in 2010 to 5.9% in 2018 (odds ratio (OR) trend 1.10; P < 0.001). Readmissions for upper GIB increased from 2.4% in 2010 to 7.8% in 2018 (OR trend 1.22; P < 0.001). On the other hand, lower GIB readmissions decreased from 7.2% in 2010 to 4.7% in 2018 (OR trend 0.95; P = 0.015). There was no statistically significant trend for all GIB readmissions (OR trend 1; P = 0.915). Further studies are needed to evaluate the patterns of lower GIB in patients with liver disease and the recent trends of corticosteroids use in AH patients.
Sections du résumé
Background
UNASSIGNED
Alcohol consumption is associated with numerous hepatic manifestations, including alcoholic fatty liver disease, alcoholic hepatitis (AH), and liver cirrhosis. AH is a common and serious complication of alcohol use. Gastrointestinal bleeding (GIB) remains one of the most common causes of death in these patients. In this article, we studied the trends of GIB after AH.
Methods
UNASSIGNED
This was a retrospective interrupted trend study. We analyzed the 2010, 2012, 2014, 2016, and 2018 Nationwide Readmission Databases. The first AH hospitalization in the year was marked as index hospitalization. We identified subsequent hospitalizations with GIB within 30 days and marked them as readmissions. A multivariate regression analysis was used to calculate the risk-adjusted odds of trends for GIB readmissions, including esophageal varices bleeding (EVB), upper GIB, lower GIB, and all GIB.
Results
UNASSIGNED
The volume of index hospitalizations increased from 10,248 in 2010 to 16,479 in 2018. Similarly, all readmissions increased from 1,838 in 2010 to 3,908 in 2018. Of all readmissions, EVB increased from 3.9% in 2010 to 5.9% in 2018 (odds ratio (OR) trend 1.10; P < 0.001). Readmissions for upper GIB increased from 2.4% in 2010 to 7.8% in 2018 (OR trend 1.22; P < 0.001). On the other hand, lower GIB readmissions decreased from 7.2% in 2010 to 4.7% in 2018 (OR trend 0.95; P = 0.015). There was no statistically significant trend for all GIB readmissions (OR trend 1; P = 0.915).
Conclusion
UNASSIGNED
Further studies are needed to evaluate the patterns of lower GIB in patients with liver disease and the recent trends of corticosteroids use in AH patients.
Identifiants
pubmed: 35836704
doi: 10.14740/gr1526
pmc: PMC9239494
doi:
Types de publication
Journal Article
Langues
eng
Pagination
136-141Informations de copyright
Copyright 2022, Laswi et al.
Déclaration de conflit d'intérêts
None to declare.
Références
Clin Gastroenterol Hepatol. 2017 Jan;15(1):5-12
pubmed: 27979049
Aliment Pharmacol Ther. 2008 Jun;27(12):1167-78
pubmed: 18363896
JAMA Netw Open. 2020 Oct 1;3(10):e2020172
pubmed: 33034641
Clin Gastroenterol Hepatol. 2012 Jan;10(1):65-71.e3
pubmed: 21946124
Ann Intern Med. 2020 Sep 1;173(5):325-330
pubmed: 32628532
Gut. 2011 Feb;60(2):255-60
pubmed: 20940288
Hepatology. 2011 Aug;54(2):555-61
pubmed: 21567436
World J Hepatol. 2021 Dec 27;13(12):2128-2136
pubmed: 35070013
Dig Dis Sci. 2006 Sep;51(9):1637-43
pubmed: 16927139
Ann Transl Med. 2019 Sep;7(18):480
pubmed: 31700916
Hepatology. 2017 Dec;66(6):1842-1853
pubmed: 28646515
Gastroenterology. 2013 Jun;144(7):1384-93, 1393.e1-2; quiz e18-9
pubmed: 23470619
J Clin Gastroenterol. 2015 Jul;49(6):506-11
pubmed: 25198164
World J Gastroenterol. 2010 May 21;16(19):2435-9
pubmed: 20480532
United European Gastroenterol J. 2021 Jun;9(5):543-551
pubmed: 33956403
Gastroenterology Res. 2021 Dec;14(6):334-339
pubmed: 35059067
Gastroenterology. 2017 Aug;153(2):480-487.e1
pubmed: 28479379
J Hepatol. 1992 May;15(1-2):170-3
pubmed: 1506636
Ann Intern Med. 1990 Aug 15;113(4):299-307
pubmed: 2142869
Endosc Int Open. 2021 Jun;9(6):E777-E789
pubmed: 34079858
BMC Gastroenterol. 2015 Sep 11;15:116
pubmed: 26362871
Alcohol Clin Exp Res. 2016 Jun;40(6):1295-303
pubmed: 27147285
Am J Med Sci. 2020 Apr;359(4):206-211
pubmed: 32087941
J Hepatol. 2011 Apr;54(4):760-4
pubmed: 21126790
Ann Gastroenterol. 2017;30(2):152-160
pubmed: 28243035
EBioMedicine. 2019 Jul;45:511-518
pubmed: 31278069
JAMA. 2004 Mar 10;291(10):1238-45
pubmed: 15010446
Gastroenterology. 1990 Jul;99(1):195-9
pubmed: 2344925
Am J Gastroenterol. 2009 Jul;104(7):1633-41
pubmed: 19574968
World J Hepatol. 2019 Jan 27;11(1):74-85
pubmed: 30705720
Intensive Care Med. 2019 Nov;45(11):1540-1549
pubmed: 31501997
Eur J Gastroenterol Hepatol. 2020 Sep;32(9):1160-1167
pubmed: 31834054
J Clin Gastroenterol. 2011 Sep;45(8):714-9
pubmed: 21085006
JAMA Psychiatry. 2017 Sep 1;74(9):911-923
pubmed: 28793133
Alcohol Clin Exp Res. 2018 Feb;42(2):352-359
pubmed: 29293274
JAMA Netw Open. 2020 Apr 1;3(4):e201997
pubmed: 32239220
Hepatology. 1997 Jan;25(1):108-11
pubmed: 8985274
Am J Med. 2019 Jun;132(6):758-766
pubmed: 30660572