Rasheed Waqas, Abu-Hassan Falah
Department of Internal Medicine, Texas Tech University Health Science Center at Amarillo, Amarillo, Texas.
Proc (Bayl Univ Med Cent). 2023 Feb 3;36(3):277-285. doi: 10.1080/08998280.2023.2172295. eCollection 2023.
Gastrointestinal angiodysplasia (GIAD) is the presence of aberrant blood vessels in the gastrointestinal (GI) tract that can lead to GI bleeding. There has been an increase in the incidence of GI angiodysplasia, partly due to the availability of better diagnostic techniques. The cecum is known as the most common site for GIAD; therefore, GIAD is considered a frequent cause of lower GI bleeding. Studies have shown an increasing incidence of GIAD in the upper GI tract and jejunum. No population-based studies exist on inpatient outcomes of GIAD-bleeding (GIADB) in recent years, and no prior studies have compared the inpatient outcomes of upper vs lower GIADB. We identified 321,559 weighted hospitalizations and found a 32% increase in GIADB-related hospitalizations from 2011 to 2020. There were more hospitalizations for upper (57.38%) than lower GIADB (42.62%), indicating GIADB is an important cause of upper GI bleeding as well. No statistically significant difference in mortality was found between upper and lower GIADB cohorts; however, lower GIADB was associated with a 0.2-day longer length of stay (95% confidence interval 0.09-0.30, <0.001) and $3857 higher mean inpatient cost (95% confidence interval $2422-$5291, <0.001).
胃肠道血管发育异常（GIAD）是指胃肠道（GI）中存在异常血管，可导致胃肠道出血。GIAD的发病率有所上升，部分原因是有了更好的诊断技术。盲肠是已知GIAD最常见的部位；因此，GIAD被认为是下消化道出血的常见原因。研究表明，GIAD在上消化道和空肠中的发病率呈上升趋势。近年来，尚无基于人群的GIAD出血（GIADB）住院患者结局的研究，也没有先前的研究比较过上消化道与下消化道GIADB的住院患者结局。我们确定了321,559例加权住院病例，发现2011年至2020年期间与GIADB相关的住院病例增加了32%。上消化道GIADB的住院病例（57.38%）多于下消化道GIADB（42.62%），这表明GIADB也是上消化道出血的重要原因。上消化道和下消化道GIADB队列之间的死亡率没有统计学上的显著差异；然而，下消化道GIADB的住院时间延长了0.2天（95%置信区间0.09 - 0.30，<0.001），平均住院费用高出3857美元（95%置信区间2422美元 - 5291美元，<0.001）。
