GI Bleeding Deaths on the Decline With Therapeutic Advances

The number of patients who are dying because of upper GI bleeding has decreased over the past 2 decades, according to a study reported at the American College of Gastroenterology 77th Annual Scientific Meeting in Las Vegas. Researchers from Harvard Medical School and Brigham and Women’s Hospital attributed the reduced mortality rate to advances in medical and endoscopic therapies.

Data from the Nationwide Inpatient Sample were analyzed in the study, “The Inpatient Mortality Rate for Upper Gastrointestinal Hemorrhage (UGIH) is Decreasing in the United States: A Nationwide Analysis Over Two Decades,” to determine the incidence, mortality, and resource utilization rates for upper GI bleeding in a nationally representative data base.

From 1989 to 2009, the inpatient mortality rate for total variceal and nonvariceal UGIH “steadily decreased” from 4.69% to 2.13%, in spite of similar patient age and medical conditions. The proportion of patients who underwent in-hospital endoscopic therapy increased from 2% to 27%; the length of hospital stay progressively decreased from 4.5 days to 2.8 days. The overall hospital-based economic burden of UGIH increased from $3.3 billion to more than $7.6 billion, more than doubled.

The study suggests that mortality resulting from upper GI bleeding is being decreased and more efficiently than before, the investigators noted. In addition, the rate of decline in mortality resulting from upper GI bleeding is faster than the overall rate of decline in mortality for all patients admitted to hospitals, suggesting that improved treatments specific to gastroenterology are responsible for this change.