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Upper versus lower gastrointestinal bleeding: A direct comparison of clinical presentation, outcomes, and resource utilization

✍ Scribed by Chad T. Whelan; Connie Chen; Peter Kaboli; Juned Siddique; Micah Prochaska; David O. Meltzer


Book ID
102341638
Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
139 KB
Volume
5
Category
Article
ISSN
1553-5592

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✦ Synopsis


Abstract

PURPOSE:

To compare prevalence, clinical outcomes, and resource utilization between subjects with lower gastrointestinal bleeding (LGIB) and upper gastrointestinal bleeding (UGIB).

METHODS:

Using administrative data, patient surveys, and chart abstraction, comparisons between subjects admitted with LGIB and UGIB were made by employing bivariate and multivariate statistics.

RESULTS:

A total of 367 subjects were identified, LGIB = 187 and UGIB = 180. Subjects with UGIB compared to LGIB had greater admission hemodynamic instability including tachycardia and orthostasis but clinical outcomes were similar. In multivariate analyses, no significant differences were observed for in‐hospital mortality transfer to the intensive care unit (ICU) or 30‐day readmission rate. Resource utilization was similar in UGIB and LGIB, including mean costs, length of stay, and number of endoscopic procedures.

CONCLUSIONS:

Unlike prior studies, this direct comparison of LGIB to UGIB identified more similarities than differences with similar prevalence rates, clinical outcomes, and resource utilization, suggesting that the epidemiology of gastrointestinal bleeding may be changing. Journal of Hospital Medicine 2010;5:141–147. © 2010 Society of Hospital Medicine.