Nonvariceal upper gastrointestinal bleeding in COVID-19 patients: insights from the National Inpatient Sample

Department

Internal Medicine

Additional Department

Gastroenterology

Document Type

Article

Publication Title

Scandinavian Journal of Gastroenterology

Abstract

BACKGROUND: This retrospective study, conducted using the U.S. National Inpatient Sample (NIS), examines the outcomes and management of nonvariceal upper gastrointestinal bleeding (NVUGIB) in COVID-19 patients and identifies predictive factors to enhance patient prognosis.

METHODS: We analyzed the 2020 U.S. NIS data involving adult patients (≥ 18 years) admitted with NVUGIB and categorized them based on the presence of COVID-19. Primary and secondary outcomes, NVUGIB-related procedures, and predictive factors were evaluated.

RESULTS: Of 184,885 adult patients admitted with NVUGIB, 1.6% (2990) had COVID-19. Patients with NVUGIB and COVID-19 showed higher inpatient mortality, acute kidney injury, need for intensive care, and resource utilization metrics. Notably, there was a lower rate of early esophagogastroduodenoscopy (EGD). Multivariate logistic regression revealed conditions like peptic ulcer disease, mechanical ventilation, and alcohol abuse as significant positive predictors for NVUGIB in COVID-19 patients, whereas female gender and smoking were negative predictors.

CONCLUSION: Our findings suggest that COVID-19 significantly increases the risk of mortality and complications in NVUGIB patients. The observed decrease in early EGD interventions, potentially contributing to higher mortality rates, calls for a review of treatment strategies. Further multicenter, prospective studies are needed to validate these results and improve patient care strategies.

First Page

615

Last Page

622

DOI

10.1080/00365521.2024.2310161

Volume

59

Issue

5

Publication Date

5-1-2024

Medical Subject Headings

Humans; COVID-19 (complications, epidemiology, mortality); Male; Female; Gastrointestinal Hemorrhage (etiology, mortality, therapy); Retrospective Studies; Middle Aged; Aged; United States (epidemiology); Hospital Mortality; Adult; SARS-CoV-2; Risk Factors; Inpatients (statistics & numerical data); Aged, 80 and over; Prognosis; Endoscopy, Digestive System; Hospitalization (statistics & numerical data)

PubMed ID

38305194

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