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Hospitalizations, deaths due to GI complications decreasing
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Hospitalizations and deaths related to gastrointestinal complications decreased throughout the United States during the previous decade, according to recent study results.
Using a national inpatient database, researchers established yearly projections for rates of hospitalization and death because of GI complications from 2001-2009. Incorporated symptoms included bleeding, perforation, obstruction and undefined bleeding.
The number of GI complications ranged from 81,677 in 2001 to 110,517 in 2009. Investigators found that the incidence of complications per 100,000 people decreased slightly but not significantly from 2001 to 2009 (from 236.1 to 223.7, P=.058) after adjusting for age and sex. This decrease occurred specifically in upper gastrointestinal (UGI) complications, which fell from 85.0 to 66.0 per 100,000 people (P=.003). Incidence of lower gastrointestinal (LGI) complications increased from 100.3 to 104.4 per 100,000 people (P=.555), and undefined bleeding increased from 50.8 to 53.3 per 100,000 people (P=.342).
Incidence of UGI bleeding decreased over time (from 78.4 to 60.6 incidents per 100,000 people, P=.004), while LGI bleeding decreased from 41.8 to 35.7 incidents per 100,000 people (P=.02). However, an increase in LGI obstructions was observed, from 55.0 to 66.0 incidents per 100,000 people (P<.001). Researchers also found that cases involving patients aged 65 years or younger increased annually during the decade, from 36.2% in 2001 to 40.4% in 2009.
Overall case fatality also decreased from 2001-2009, from 3.78% of cases to 2.70% (P<.001), after adjustment for age and sex. Deaths from UGI complications decreased from 3.61% to 2.87% (P=.002), while the LGI fatality rate decreased from 3.53% to 2.44% (P<.001). This decrease occurred in both sexes and across all age groups.
“Physicians and health care planners will need to explore potential reasons for the increase in LGI obstruction and develop interventions to decrease this complication,” the researchers wrote. “Furthermore, health care providers can reassure their patients about the low and decreasing risk of death with GI bleeding and obstruction.”
Disclosure: Loren Laine, MD, served as a consultant for and researchers Huiying Yang, PhD; Shih-Chen Chang, PhD; and Catherine Datto, MD, are employees of AstraZeneca, which provided financial support for the study.
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