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Lower gastrointestinal hemorrhage incidence increased; mortality rate decreased
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LAS VEGAS — Despite a decrease in mortality rates for lower gastrointestinal hemorrhage, its incidence has steadily risen in recent years, according to data presented at the 2012 American College of Gastroenterology Annual Scientific Meeting.
Researchers assessed data collected from the Nationwide Inpatient Sample in 5-year increments from 1989 and 2009 on patients with lower gastrointestinal hemorrhage (LGIH). Incidence of inpatient mortality was recorded, along with the median length of hospital stay, the number of patients who underwent inpatient endoscopy and the total charge and economic burden incurred because of the condition.
Overall LGIH-related mortality rates decreased consistently from 1989 through 2009 (1.61% of cases in 1989, 1.88% in 1994, 1.58% in 1999, 1.29% in 2004, and 1.15% in 2009). This decrease also occurred specifically among patients aged older than 65 years (3.22% in 1989, 2.31% in 1994, 1.95% in 1999, 1.59% in 2004, and 1.41% in 2009), while patients aged younger than 65 years maintained stable LGIH mortality rates (0.39% in 1989, 0.80% in 1994, 0.56% in 1999, 0.54% in 2004, and 0.57% in 2009). During the same period, LGIH incidence rose from 27 per 100,000 people in 1989 to 59 per 100,000 in 2009.
Patients in the cohort who received inpatient endoscopy decreased steadily from 80% in 1989 to 52.08% in 2009, as the percentage of therapeutic endoscopies included in the total number performed grew steadily from 1% to 8.17% over the same period. Investigators also noted that the median total charge and adjusted total economic burden increased between 1989 and 2009 (total charge from $5,628 to $17,830; economic burden from $534 million to $4.87 billion.
Researcher John R. Saltzman, MD, director of endoscopy at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School, told Healio.com that the decrease in mortality rates follows the same trend experienced by all hospitalized patients during the evaluated period.
“[It is] likely the improvements to mortality are related to general care in the hospital: Improvements to intensive care units, to nursing care, but not GI-specific therapy,” Saltzman said. “We’re not doing an endoscopic treatment or medical treatment that’s impacting this; it’s general.”
He added that increased economic burden suggests that LGIH is a significant health care problem and that care improvements specific to this population are necessary.
For more information:
Abougergi M. P1405: The Inpatient Mortality Rate for Lower Gastrointestinal Hemorrhage is Steadily Decreasing Despite an Increasing Disease Incidence: A Longitudinal Nationwide Analysis. Presented at: the 2012 American College of Gastroenterology Annual Scientific Meeting; Oct. 19-24, Las Vegas.