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Upper versus lower gastrointestinal bleeding: A direct comparison of clinical presentation, outcomes, and resource utilization
Author(s) -
Whelan Chad T.,
Chen Connie,
Kaboli Peter,
Siddique Juned,
Prochaska Micah,
Meltzer David O.
Publication year - 2010
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.606
Subject(s) - medicine , upper gastrointestinal bleeding , lower gastrointestinal bleeding , gastrointestinal bleeding , multivariate analysis , epidemiology , intensive care unit , emergency medicine , intensive care medicine , endoscopy , colonoscopy , colorectal cancer , cancer
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.