End‐stage renal disease and lower gastrointestinal bleeding—A propensity‐matched analysis of nationwide inpatient sample. Issue 2 (4th December 2020)

• Record Type: Journal Article
• Authors: Garlapati, Pavani; Gajjar, Bhavesh; Then, Eric O.; Gayam, Vijay
• Is Part Of: International journal of clinical practice. Volume 75:Issue 2(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-04
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.13633
• Languages: English
• ISSNs: 1368-5031

Abstract

Abstract: Aims: We aim to determine the influence of lower gastrointestinal bleeding (LGIB) on mortality, morbidity, length of hospital stay and resource utilisation in end‐stage renal disease (ESRD) patients. Material and Methods: The National Inpatient Sample database (2016 &2017) was used for data analysis using the International Classification of Diseases, Tenth Revision codes to identify the patients with the principal diagnosis of ESRD and LGIB. We assessed the all‐cause in‐hospital mortality, morbidity, predictors of mortality, length of hospital stay (LOS) and total costs between propensity‐matched groups of ESRD patients with LGIB versus ESRD patients. Results: We identified 2 187 954 ESRD patients, of whom 242 075 has LGIB, and 1 945 879 were ESRD patients. The in‐hospital mortality was higher in ESRD with LGIB (OR 2.5, 95% CI 1.5‐2.2; P = .00). ESRD with LGIB has higher odds of mechanical ventilation (OR 1.4, 95% CI 6.4‐16.4; P = .00), and shock requiring vasopressor (OR 1.2, 95% CI 4.9‐5.4; P = .002). Advanced age (OR 1.02 CI 1.02‐1.03 P = .00), anaemia (OR 1.04 CI 1.59‐1.91 P = .006), acute coronary syndrome (OR 1.8 CI 1.6‐2.1, P = .00), acute respiratory failure (OR 1.29 CI 2.0‐2.6, P = .00), mechanical ventilation (OR 1.9, CI 3.5‐4.4, P = .00) and sepsis (OR 1.5, CI 4.1‐5.08, P = .00) were identified as predictors of mortality in ESRD with LGIB. Mean LOS (10.8 ± 14.9 vs 6.3 ± 8.5, P < .01) and mean total charges (37 054 $ vs 18 080 $, P < .01) were also higher. Conclusions: In this propensity‐matched analysis, ESRD with LGIB was associated with higher odds of in‐hospital mortality, mechanical ventilation and shock requiring vasopressor. Mean LOS and resource utilisation were also higher.