Ulcer Bleeding in the United States : Epidemiology, Treatment Success, and Resource Utilization
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature..
BACKGROUND AND GOALS: Peptic ulcer disease is the most frequent cause of upper gastrointestinal bleeding. We sought to establish the epidemiology and hemostasis success rate of the different treatment modalities in this setting.
METHODS: Retrospective cohort study using the National Inpatient Sample. Non-elective adult admissions with a principal diagnosis of ulcer bleeding were included. The primary outcome was endoscopic, radiologic and surgical hemostasis success rate. Secondary outcomes were patients' demographics, in-hospital mortality and resource utilization. On subgroup analysis, gastric and duodenal ulcers were studied separately. Confounders were adjusted for using multivariate regression analysis.
RESULTS: A total of 136,425 admissions (55% gastric and 45% duodenal ulcers) were included. The mean patient age was 67 years. The majority of patients were males, Caucasians, of lower income and high comorbidity burden. The endoscopic, radiological and surgical therapy and hemostasis success rates were 33.6, 1.4, 0.1, and 95.1%, 89.1 and 66.7%, respectively. The in-hospital mortality rate was 1.9% overall, but 2.4% after successful and 11.1% after failed endoscopic hemostasis, respectively. Duodenal ulcers were associated with lower adjusted odds of successful endoscopic hemostasis, but higher odds of early and multiple endoscopies, endoscopic therapy, overall and successful radiological therapy, in-hospital mortality, longer length of stay and higher total hospitalization charges and costs.
CONCLUSIONS: The ulcer bleeding endoscopic hemostasis success rate is 95.1%. Rescue therapy is associated with lower hemostasis success and more than a ten-fold increase in mortality rate. Duodenal ulcers are associated with worse treatment outcomes and higher resource utilization compared with gastric ulcers.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Digestive diseases and sciences - (2024) vom: 06. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mujadzic, Hata [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Duodenal ulcer |
|---|
| Anmerkungen: |
Date Revised 06.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1007/s10620-024-08322-y |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369361415 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369361415 | ||
| 003 | DE-627 | ||
| 005 | 20240306233825.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240306s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10620-024-08322-y |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1318.xml |
| 035 | |a (DE-627)NLM369361415 | ||
| 035 | |a (NLM)38446313 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mujadzic, Hata |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Ulcer Bleeding in the United States |b Epidemiology, Treatment Success, and Resource Utilization |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 06.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. | ||
| 520 | |a BACKGROUND AND GOALS: Peptic ulcer disease is the most frequent cause of upper gastrointestinal bleeding. We sought to establish the epidemiology and hemostasis success rate of the different treatment modalities in this setting | ||
| 520 | |a METHODS: Retrospective cohort study using the National Inpatient Sample. Non-elective adult admissions with a principal diagnosis of ulcer bleeding were included. The primary outcome was endoscopic, radiologic and surgical hemostasis success rate. Secondary outcomes were patients' demographics, in-hospital mortality and resource utilization. On subgroup analysis, gastric and duodenal ulcers were studied separately. Confounders were adjusted for using multivariate regression analysis | ||
| 520 | |a RESULTS: A total of 136,425 admissions (55% gastric and 45% duodenal ulcers) were included. The mean patient age was 67 years. The majority of patients were males, Caucasians, of lower income and high comorbidity burden. The endoscopic, radiological and surgical therapy and hemostasis success rates were 33.6, 1.4, 0.1, and 95.1%, 89.1 and 66.7%, respectively. The in-hospital mortality rate was 1.9% overall, but 2.4% after successful and 11.1% after failed endoscopic hemostasis, respectively. Duodenal ulcers were associated with lower adjusted odds of successful endoscopic hemostasis, but higher odds of early and multiple endoscopies, endoscopic therapy, overall and successful radiological therapy, in-hospital mortality, longer length of stay and higher total hospitalization charges and costs | ||
| 520 | |a CONCLUSIONS: The ulcer bleeding endoscopic hemostasis success rate is 95.1%. Rescue therapy is associated with lower hemostasis success and more than a ten-fold increase in mortality rate. Duodenal ulcers are associated with worse treatment outcomes and higher resource utilization compared with gastric ulcers | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Duodenal ulcer | |
| 650 | 4 | |a Endoscopic hemostasis | |
| 650 | 4 | |a Gastric ulcer | |
| 650 | 4 | |a Treatment | |
| 650 | 4 | |a Ulcer hemorrhage | |
| 700 | 1 | |a Noorani, Shayan |e verfasserin |4 aut | |
| 700 | 1 | |a Riddle, Philip J |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yichen |e verfasserin |4 aut | |
| 700 | 1 | |a Metts, Gracelyn |e verfasserin |4 aut | |
| 700 | 1 | |a Yacu, Tania |e verfasserin |4 aut | |
| 700 | 1 | |a Abougergi, Marwan S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Digestive diseases and sciences |d 1989 |g (2024) vom: 06. März |w (DE-627)NLM000356492 |x 1573-2568 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:06 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s10620-024-08322-y |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 06 |c 03 | ||