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Palliative care documentation in gastrointestinal bleeding hospitalizations: national trends and associated care

Akram Alnounou1, Brian Nohomovich2, Mohammad Alabbas3

  • 1Department of Internal Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA.

Proceedings (Baylor University. Medical Center)
|August 10, 2026
PubMed

Insights

Palliative care documentation for gastrointestinal bleeding (GIB) is uncommon, affecting only 2.7% of hospitalizations. Documentation increased slightly from 2016-2022 but was linked to higher acuity care and longer stays.

Area of Science:

  • Geriatric Medicine
  • Palliative Care
  • Gastroenterology

Background:

  • Gastrointestinal bleeding (GIB) disproportionately affects older, medically complex individuals.
  • National data on palliative care documentation for GIB patients are lacking.
  • Understanding palliative care patterns is crucial for improving care for this population.

Purpose of the Study:

  • To analyze national trends in palliative care documentation for GIB hospitalizations.
  • To identify factors associated with palliative care documentation.
  • To examine the impact of palliative care documentation on inpatient care and outcomes.

Main Methods:

  • Retrospective analysis of adult GIB hospitalizations from the National Inpatient Sample (2016-2022).
  • Palliative care documentation identified using ICD-10-CM code Z51.5.
  • Survey-weighted regression models used to assess associated factors and outcomes.

Main Results:

  • Palliative care documentation was present in 2.70% of 2.4 million GIB hospitalizations, increasing from 2.13% to 3.43% (2016-2022).
  • Factors associated with documentation included metastatic cancer, advanced age (≥85), respiratory failure, and dementia.
  • Documentation correlated with reduced endoscopy use but increased mechanical ventilation and renal replacement therapy; it was also linked to higher charges and longer stays.

Conclusions:

  • Palliative care documentation for GIB remains infrequent and concentrated in high-acuity cases.
  • Current coding practices limit the ability to ascertain the true impact and timing of palliative care interventions.
  • Further research with richer clinical data is needed to validate these findings.
Abstract

Keywords:
Gastrointestinal bleedingICD-10-CM Z51.5National Inpatient Samplegoals of carepalliative care

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