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Mortality associated with gastrointestinal bleeding events: Comparing short-term clinical outcomes of patients hospitalized for upper GI bleeding and acute myocardial infarction in a US managed care setting.

Wilcox CM, Cryer BL, Henk HJ, Zarotsky V, Zlateva G - Clin Exp Gastroenterol (2009)

Bottom Line: Propensity score matching yielded 6,923 matched pairs.Matched cohorts were found to have a similar Charlson Comorbidity Index score and to be similar on nearly all utilization and cost measures (excepting emergency room costs).GI bleeding events result in significant mortality similar to that of an AMI after adjusting for the initial hospitalization.

View Article: PubMed Central - PubMed

Affiliation: University of Alabama, Birmingham, AL, USA;

ABSTRACT

Objectives: To compare the short-term mortality rates of gastrointestinal (GI) bleeding to those of acute myocardial infarction (AMI) by estimating the 30-, 60-, and 90-day mortality among hospitalized patients.

Methods: United States national health plan claims data (1999-2003) were used to identify patients hospitalized with a GI bleeding event. Patients were propensity-matched to AMI patients with no evidence of GI bleed from the same US health plan.

Results: 12,437 upper GI-bleed patients and 22,847 AMI patients were identified. Propensity score matching yielded 6,923 matched pairs. Matched cohorts were found to have a similar Charlson Comorbidity Index score and to be similar on nearly all utilization and cost measures (excepting emergency room costs). A comparison of outcomes among the matched cohorts found that AMI patients had higher rates of 30-day mortality (4.35% vs 2.54%; p < 0.0001) and rehospitalization (2.56% vs 1.79%; p = 0.002), while GI bleed patients were more likely to have a repeat procedure (72.38% vs 44.95%; p < 0.001) following their initial hospitalization. The majority of the difference in overall 30-day mortality between GI bleed and AMI patients was accounted for by mortality during the initial hospitalization (1.91% vs 3.58%).

Conclusions: GI bleeding events result in significant mortality similar to that of an AMI after adjusting for the initial hospitalization.

No MeSH data available.


Related in: MedlinePlus

Post-matched mortality for gastrointestinal (GI) bleed and acute myocardial infarction (AMI) during and following initial hospitalization.
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f2-ceg-2-021: Post-matched mortality for gastrointestinal (GI) bleed and acute myocardial infarction (AMI) during and following initial hospitalization.

Mentions: The overall 30-, 60-, and 90-day mortality rates for the GI cohort were 2.54%, 3.12%, and 3.42%, respectively. These overall mortality rates were lower than the corresponding mortality rates of the matched cohort of AMI patients (4.35%, 4.78%, and 5.06%, respectively), as shown in Figure 2. The majority of the difference in overall 30-day mortality between GI bleed and AMI patients (2.54% vs 4.35%) was accounted for by mortality during the initial hospital stay (1.91% vs 3.58%). The 30-day mortality excluding those within the initial hospitalization did not differ between the cohorts (0.64% vs 0.77%). When mortality during the initial hospitalization was removed from the 60- and 90-day mortality rates, results between cohorts were similar. The “adjusted” 60-day mortality rates in the GI bleed and AMI cohorts were 1.21% and 1.20%, respectively, while the 90-day rates were 1.52% and 1.47%, respectively.


Mortality associated with gastrointestinal bleeding events: Comparing short-term clinical outcomes of patients hospitalized for upper GI bleeding and acute myocardial infarction in a US managed care setting.

Wilcox CM, Cryer BL, Henk HJ, Zarotsky V, Zlateva G - Clin Exp Gastroenterol (2009)

Post-matched mortality for gastrointestinal (GI) bleed and acute myocardial infarction (AMI) during and following initial hospitalization.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108636&req=5

f2-ceg-2-021: Post-matched mortality for gastrointestinal (GI) bleed and acute myocardial infarction (AMI) during and following initial hospitalization.
Mentions: The overall 30-, 60-, and 90-day mortality rates for the GI cohort were 2.54%, 3.12%, and 3.42%, respectively. These overall mortality rates were lower than the corresponding mortality rates of the matched cohort of AMI patients (4.35%, 4.78%, and 5.06%, respectively), as shown in Figure 2. The majority of the difference in overall 30-day mortality between GI bleed and AMI patients (2.54% vs 4.35%) was accounted for by mortality during the initial hospital stay (1.91% vs 3.58%). The 30-day mortality excluding those within the initial hospitalization did not differ between the cohorts (0.64% vs 0.77%). When mortality during the initial hospitalization was removed from the 60- and 90-day mortality rates, results between cohorts were similar. The “adjusted” 60-day mortality rates in the GI bleed and AMI cohorts were 1.21% and 1.20%, respectively, while the 90-day rates were 1.52% and 1.47%, respectively.

Bottom Line: Propensity score matching yielded 6,923 matched pairs.Matched cohorts were found to have a similar Charlson Comorbidity Index score and to be similar on nearly all utilization and cost measures (excepting emergency room costs).GI bleeding events result in significant mortality similar to that of an AMI after adjusting for the initial hospitalization.

View Article: PubMed Central - PubMed

Affiliation: University of Alabama, Birmingham, AL, USA;

ABSTRACT

Objectives: To compare the short-term mortality rates of gastrointestinal (GI) bleeding to those of acute myocardial infarction (AMI) by estimating the 30-, 60-, and 90-day mortality among hospitalized patients.

Methods: United States national health plan claims data (1999-2003) were used to identify patients hospitalized with a GI bleeding event. Patients were propensity-matched to AMI patients with no evidence of GI bleed from the same US health plan.

Results: 12,437 upper GI-bleed patients and 22,847 AMI patients were identified. Propensity score matching yielded 6,923 matched pairs. Matched cohorts were found to have a similar Charlson Comorbidity Index score and to be similar on nearly all utilization and cost measures (excepting emergency room costs). A comparison of outcomes among the matched cohorts found that AMI patients had higher rates of 30-day mortality (4.35% vs 2.54%; p < 0.0001) and rehospitalization (2.56% vs 1.79%; p = 0.002), while GI bleed patients were more likely to have a repeat procedure (72.38% vs 44.95%; p < 0.001) following their initial hospitalization. The majority of the difference in overall 30-day mortality between GI bleed and AMI patients was accounted for by mortality during the initial hospitalization (1.91% vs 3.58%).

Conclusions: GI bleeding events result in significant mortality similar to that of an AMI after adjusting for the initial hospitalization.

No MeSH data available.


Related in: MedlinePlus