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Older patients at greater risk for PCI-related gastrointestinal bleeding

31 Jan 2019

There appears to be an increase in inpatient incidence and mortality for gastrointestinal bleeding (GIB) related to percutaneous coronary intervention (PCI), particularly among older patients, a recent study has found.

There were 9,332 (1.2 percent) recorded PCI hospitalizations complicated by GIB, with an age-adjusted incidence rate increase of 13 percent from 2007 (11.3 GIB per 1,000 PCI) to 2012 (12.8 GIB per 1,000 PCI). Older patients (aged ≥75 years) had the highest increase in GIB incidence, rising 31 percent during the study period.

GIB vs non-GIB patients had significantly higher mean length of stay (9.4 vs 3.3 days) and median cost of care ($29,236 vs $17,913). Risk factors for GIB included the following: older age, gastritis or duodenitis, and Helicobacter pylori infection.

A total of 1,044 (11 percent) GIB patients succumbed to death during hospitalization, with GIB mortality rate increasing 30 percent from 2007 (95 deaths per 1,000 GIB) to 2012 (123 deaths per 1,000 GIB). Older age was the strongest predictor of inpatient mortality.

“A multidisciplinary approach focused on risk-stratifying patients may improve preventable causes of GIB,” the investigators said.

This nested case-control study evaluated the impact of inpatient outcomes, including incidence and mortality of PCI-related GIB hospitalizations, using the National Inpatient Sample (2007–2012). Multivariate logistic regression analyses were conducted to examine significant risk factors for GIB incidence and mortality.

“With all-cause mortality increasing in patients undergoing PCIs, outcomes for GIB associated with PCI may be adversely impacted,” according to the investigators.

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