B0460 - Outcomes in Hospitalized Patients With Coagulopathy (COAG) Presenting With Nonvariceal Upper Gastrointestinal Bleed (NVUGIB) - 4-Year NIS Study (2016 -2019)

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Sriram B. Chowdary, MD

Geisinger Health System
South Abington Township, PA

Sriram B. Chowdary, MD¹, Dhruv Lowe, MD¹, Abhinav Goyal, MD¹, Kishore Kumar, MD¹, Divey Manocha, MD¹, Birendra Amgai, MD¹, Duane Deivert, MD¹, Swathi Gopishetty, MD²
¹Geisinger Health System, Scranton, PA; ²Geisinger Health System, Wilkes-Barre, PA

Introduction: Introduction: Coagulopathy is a major public health issue worldwide resulting in mortality and morbidity. (1) Primary coagulation disorders include defect in platelets or blood vessels. (2) Secondary coagulation disorders involve qualitative or quantitative defects in clotting factors or their inhibitors. (3) Acquired coagulation disorder is mainly associated with chronic diseases like liver disease, vitamin K deficiency, disseminated intravascular coagulation (DIC), and anticoagulant therapy [4] Limited data is available to determine the impact of coagulopathy on non-variceal upper gastrointestinal bleed.

Methods: Methods: Using National Inpatient Sample databases from 2016 to 2019(5), we identified patients presenting with Non variceal gastrointestinal bleed (NVUGIB), the population were then divided based on the presence and absence of coagulopathy using appropriate ICD-10-CM/PCS codes. STATA 17.0 software (6) was used for the analysis. Pearson’s Chi-Square test was used to analyze categorical variable, whereas the student t-test was used to analyze continuous variables. Univariate and multivariate logistic regression was used to adjust for potential confounders. Primary outcome was in hospital mortality due to NVUGIB in patients with coagulopathy vs without coagulopathy.

Results: Results: Amongst total of 1,515,460 patients admitted with non-variceal upper gastrointestinal bleed, 120,060 (7.92%) patients had coagulopathy disorder. Male gender and white ethnicity were predominant in both populations. There were 7,408(6.17%) and 27,017(1.94%) mortality in patients with and without coagulopathy respectively. The difference is statistically significant with OR:1.7, 95% CI: 1.63-1.93, and p < 0.001. Additionally, complications such as hypovolemic shock, pressor support, acute respiratory failure were higher in patients with coagulopathy. Odds of using IR intervention were higher and EGD were lower in patients with coagulopathy as shown in table 2. Mean length of stay 5.72 (5.64-5.80) vs 4.14 (4.12-4.16) {Days: p-value < 0.001} and hospitalization charges (mean US$: 20143 vs. 12390) were also higher in patients with coagulopathy.

Discussion: Conclusions: Patients with coagulopathy presenting with NVUGIB were younger, had higher resource utilization, and were associated with higher in-patient mortality and complications. Coagulopathy, whether congenital or acquired, is a risk factor for adverse hospital outcome for patients admitted with NVUGIB.

Variables	Odds ratio	95% CI	P value
In-patient mortality	1.7	1.63-1.93	< 0.001
ALL EGD	.7666	0.74-0.79	< 0.001
EGD with intervention	.9674	0.92-1.00	0.111
IR intervention	1.26	3.7-9.8	0.007
Acute Respiratory Failure	2.06	1.91-2.23	< 0.001
Hypovolemic Shock	1.96	1.82-2.12	< 0.001
Requiring pressor Support	1.88	1.60-2.22	< 0.001
Blood Products Transfusion	1.34	1.29 – 1.39	< 0.001

Table: Table 1: In Patient Outcomes

Disclosures:

Sriram Chowdary indicated no relevant financial relationships.

Dhruv Lowe indicated no relevant financial relationships.

Abhinav Goyal indicated no relevant financial relationships.

Kishore Kumar indicated no relevant financial relationships.

Divey Manocha indicated no relevant financial relationships.

Birendra Amgai indicated no relevant financial relationships.

Duane Deivert indicated no relevant financial relationships.

Swathi Gopishetty indicated no relevant financial relationships.

Sriram B. Chowdary, MD¹, Dhruv Lowe, MD¹, Abhinav Goyal, MD¹, Kishore Kumar, MD¹, Divey Manocha, MD¹, Birendra Amgai, MD¹, Duane Deivert, MD¹, Swathi Gopishetty, MD². B0460 - Outcomes in Hospitalized Patients With Coagulopathy (COAG) Presenting With Nonvariceal Upper Gastrointestinal Bleed (NVUGIB) - 4-Year NIS Study (2016 -2019), ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.