Comorbidities Associated with Worse Outcomes Among Inpatients Admitted for Acute Gastrointestinal Bleeding

Area of Science:

• Gastroenterology
• Healthcare Management
• Clinical Epidemiology

Background:

• Multimorbidity significantly elevates healthcare resource utilization.
• Specific comorbidity combinations and their impact on resource use remain under-researched.
• Understanding these associations is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To identify specific comorbidities linked to increased healthcare resource utilization in patients hospitalized for gastrointestinal bleeding (GIB).
• To analyze the association between comorbidities and length of stay (LOS) and 30-day readmissions.
• To provide data for developing targeted management strategies for GIB patients with complex comorbidities.

Main Methods:

• Retrospective cross-sectional study analyzing electronic health records from 2010-2018.
• Inclusion of patients with upper (UGIB) and lower (LGIB) gastrointestinal bleeding.
• Multivariable regression analysis adjusted for antithrombotic use to assess resource utilization (LOS, 30-day readmissions).

Main Results:

• Antithrombotic use independently increased LOS in both UGIB (46%) and LGIB (25%).
• Cancer independently associated with increased 30-day readmissions in both UGIB (OR 2.86) and LGIB (OR 4.76).
• Thromboembolic events and anemia showed trends toward increased LOS in UGIB; atrial fibrillation/flutter strongly associated with readmissions in LGIB.

Conclusions:

• Cancer and antithrombotic use are key factors associated with increased LOS and 30-day readmissions in GIB patients.
• Specific comorbidities like thromboembolic events, anemia, and atrial fibrillation/flutter have differential impacts on outcomes in UGIB vs. LGIB.
• Prospective studies are recommended to validate findings and develop evidence-based guidelines for managing complex multimorbid GIB populations.