Aldiabat Mohammad, Aleyadeh Wesam, Muzammil Taimur, Adewuyi Kemi, Alahmad Majd, Jabri Ahmad, Alhuneafat Laith, Kilani Yassine, Alsakarneh Saqr, Bilal Mohammad
Harvard T.H. Chan School of Public Health, Harvard University, Boston, 02115, USA.
Department of Medicine, Cleveland Clinic Akron General, Akron, 44307, USA.
Curr Med Sci. 2024 Dec;44(6):1202-1209. doi: 10.1007/s11596-024-2838-6. Epub 2024 Dec 14.
This study aimed to investigate the incidence and predictors of non-variceal upper gastrointestinal bleeding (NVUGIB) in hospitalized patients with coronavirus disease 2019 (COVID-19), as well as the inpatient outcomes associated with this complication.
This was an analysis of the National Inpatient Sample Database from January to December 2020. Adult COVID-19 patients were categorized into two groups based on NVUGIB development during hospitalization. Multivariate logistic analysis was performed to identify predictors and outcomes associated with NVUGIB in hospitalized COVID-19 patients in the US, after adjusting for age, sex, race, and Charlson Comorbidity Index (CCI) score, using Stata/BE 17.0.
Among 1 050 045 hospitalized patients, 1.87% developed NVUGIB. Asian Americans had the highest risk, followed by Native Americans, Hispanics, and African Americans, with odds ratios (ORs) of 1.70, 1.59, 1.40, and 1.14, respectively. Patients with higher CCI scores were also at greater risk (with ORs of 1.47, 2.09, and 3.45 for CCI scores of 1, 2, and 3, respectively). COVID-19 patients with NVUGIB had a higher risk of inpatient mortality (OR=3.84), acute kidney injury (OR=3.12), hypovolemic shock (OR=13.7), blood transfusion (OR=7.02), and in-hospital cardiac arrest (OR=4.02).
NVUGIB occurred in 1.87% of hospitalized COVID-19 patients and was associated with a threefold increase in mortality. Further research is necessary to identify strategies for reducing its incidence in COVID-19 patients with multiple risk factors.
本研究旨在调查2019冠状病毒病（COVID-19）住院患者中非静脉曲张性上消化道出血（NVUGIB）的发生率及预测因素，以及与该并发症相关的住院结局。
这是一项对2020年1月至12月国家住院患者样本数据库的分析。成年COVID-19患者根据住院期间是否发生NVUGIB分为两组。使用Stata/BE 17.0，在调整年龄、性别、种族和查尔森合并症指数（CCI）评分后，进行多因素逻辑分析，以确定美国住院COVID-19患者中与NVUGIB相关的预测因素和结局。
在1050045例住院患者中，1.87%发生了NVUGIB。亚裔美国人风险最高，其次是美洲原住民、西班牙裔和非裔美国人，优势比（OR）分别为1.70、1.59、1.40和1.14。CCI评分较高的患者风险也更高（CCI评分为1、2和3时，OR分别为1.47、2.09和3.45）。发生NVUGIB的COVID-19患者住院死亡率（OR=3.84）、急性肾损伤（OR=3.12）、低血容量性休克（OR=13.7）、输血（OR=7.02）和院内心脏骤停（OR=4.02）的风险更高。
1.87%的COVID-19住院患者发生了NVUGIB，且与死亡率增加三倍相关。有必要进一步研究，以确定降低具有多种危险因素的COVID-19患者中NVUGIB发生率的策略。
