Rasheed Waqas, Dharmarpandi Gnanashree, Al-Jobory Ola, Dweik Anass, Anil Muhammad, Islam Sameer
Department of Internal Medicine, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas.
Department of Internal Medicine, Beaumont Health Dearborn, Dearborn, Michigan.
Proc (Bayl Univ Med Cent). 2023 Feb 16;36(3):286-291. doi: 10.1080/08998280.2023.2177490. eCollection 2023.
Upper gastrointestinal bleeding results in significant morbidity, mortality, and healthcare burden. This study aimed to evaluate inpatient outcomes of nonvariceal upper gastrointestinal bleeding (NVUGIB) during the year 2020 of the COVID-19 pandemic. The National Inpatient Sample databases were used to identify NVUGIB-related hospitalizations. Outcomes of interest for the year 2019 were compared to 2020 and included inpatient mortality, length of stay, mean inpatient cost, odds of getting esophagogastroduodenoscopy (EGD), mean time to EGD, early EGD (within 1 day of hospitalization), endoscopic intervention for hemostasis, and the odds of developing complications. NVUGIB-related hospitalizations increased by 8.1% in 2020. NVUGIB-related hospitalizations in 2020 were also associated with an 11.1% higher mortality (adjusted odds ratio [aOR] = 1.11, confidence interval [CI] = 1.06-1.17, < 0.01), 0.15-day longer mean time to EGD (aOR = 0.15, CI = 0.08-0.24, < 0.01), 4% lower odds of getting an EGD (aOR = 0.96, CI = 0.93-0.99, = 0.02), 8% lower odds of getting an early EGD (aOR = 0.92, CI = 0.89-0.96, < 0.01), and $6340 higher mean inpatient cost (aOR = 6340, CI = 1762-10919, = 0.01) compared to 2019. We conclude that there was an increase in NVUGIB-related hospitalizations and mortality in 2020 when the COVID-19 pandemic started.
上消化道出血会导致严重的发病率、死亡率和医疗负担。本研究旨在评估2020年新冠疫情期间非静脉曲张性上消化道出血(NVUGIB)患者的住院结局。利用国家住院样本数据库来识别与NVUGIB相关的住院病例。将2019年的相关结局与2020年进行比较,包括住院死亡率、住院时长、平均住院费用、接受食管胃十二指肠镜检查(EGD)的几率、EGD的平均时间、早期EGD(住院1天内)、内镜止血干预以及发生并发症的几率。2020年与NVUGIB相关的住院病例增加了8.1%。与2019年相比,2020年与NVUGIB相关的住院病例死亡率也高出11.1%(调整优势比[aOR]=1.11,置信区间[CI]=1.06 - 1.17,P<0.01),EGD的平均时间长0.15天(aOR = 0.15,CI = 0.08 - 0.24,P<0.01),接受EGD的几率低4%(aOR = 0.96,CI = 0.93 - 0.99,P = 0.02),接受早期EGD的几率低8%(aOR = 0.92,CI = 0.89 - 0.96,P<0.01),平均住院费用高出6340美元(aOR = 6340,CI = 1762 - 10919,P = 0.01)。我们得出结论,在2020年新冠疫情开始时,与NVUGIB相关的住院病例和死亡率有所增加。