Key result
Among PCI hospitalizations, gastrointestinal bleeding occurred in 1.2% of cases and was associated with an 11% inpatient mortality rate, significantly increased length of stay, and higher costs.
Why the study?
Does gastrointestinal bleeding during PCI hospitalization impact inpatient mortality, length of stay, and cost of care?
Case-Control
Yes
Does gastrointestinal bleeding during PCI hospitalization impact inpatient mortality, length of stay, and cost of care?
Inpatient incidence and mortality for PCI-related gastrointestinal bleeding increased significantly between 2007 and 2012, particularly among older patients, highlighting the need for improved risk stratification.
GI bleeding during PCI hospitalization warrants heightened vigilance; leaves open whether targeted prevention reduces mortality in this high-risk group.
GOALS: The goal of this study was to evaluate the impact of inpatient outcomes of gastrointestinal bleeding (GIB) related to percutaneous coronary intervention (PCI). BACKGROUND: With all-cause mortality increasing in patients undergoing PCIs, outcomes for GIB associated with PCI may be adversely impacted. STUDY: Using the National Inpatient Sample (2007 to 2012), we performed a nested case-control study assessing inpatient outcomes including incidence and mortality for PCI-related GIB hospitalizations. Multivariate logistic regression analyses were performed to determine significant predictors for GIB incidence and mortality. RESULTS: A total of 9332 (1.2%) of PCI hospitalizations were complicated by GIB with the age-adjusted incidence rate increasing 13% from 2007 (11.3 GIB per 1000 PCI) to 2012 (12.8). Patients ≥75 years of age experienced the steepest incline in GIB incidence, which increased 31% during the study period. Compared with non-GIB patients, mean length of stay (9.4 d vs. 3.3 d) and median cost of care ($29,236 vs. $17,913) was significantly higher. Significant demographic risk factors for GIB included older age and comorbid risk factors included gastritis or duodenitis, and Helicobacter pylori infection.In total, 1044 (11%) of GIB patients died during hospitalization with the GIB mortality rate increasing 30% from 2007 (95 deaths per 1000 GIB) to 2012 (123). Older age had the strongest association with inpatient mortality. CONCLUSIONS: Inpatient incidence and mortality for PCI-related GIB has been increasing particularly with a large increase in incidence among older patients. A multidisciplinary approach focused on risk-stratifying patients may improve preventable causes of GIB.
No takes yet. Share an insight, caveat, or question.
Cholankeril et al. (2018) conducted a case-control in Gastrointestinal bleeding related to percutaneous coronary intervention. Gastrointestinal bleeding (GIB) vs. Non-GIB patients was evaluated on Inpatient outcomes including incidence and mortality. Among PCI hospitalizations, gastrointestinal bleeding occurred in 1.2% of cases and was associated with an 11% inpatient mortality rate, significantly increased length of stay, and higher costs.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: