B0683 - Peptic Ulcer Bleeding in End-Stage Renal Disease Hospitalizations: A Comparative Analysis in the United States

Dushyant S. Dahiya, MD¹, Amandeep Singh, MD², Abhilash Perisetti, MD³, Priyata Dutta, MD⁴, Rajat Garg, MD², Sailaja Pisipati, MBBS, FRCS⁵, Chin-I Cheng, PhD⁶, Sumant Inamdar, MD, MPH⁷, Madhusudhan Sanaka, MD⁸, Mohammad Al-Haddad, MD, MSc^9
1Central Michigan University College of Medicine, Saginaw, MI; ²Cleveland Clinic Foundation, Cleveland, OH; ³Parkview Cancer Institute, Fort Wayne, IN; ⁴St. Joseph Mercy, Ann Arbor, Ann Arbor, MI; ⁵Mayo Clinic, Scottsdale, AZ; ⁶Central Michigan University, Mount Pleasant, MI; ⁷University of Arkansas for Medical Sciences, Little Rock, AR; ⁸Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH; ⁹Indiana University School of Medicine, Indianapolis, IN

Introduction: Peptic ulcer bleeding (PUB), a life-threatening complication of peptic ulcer disease, has been regarded as a leading cause of upper gastrointestinal bleeding globally. Studies have reported higher rates of PUB in patients with end-stage renal disease (ESRD) secondary to a cluster of complex pathophysiological mechanisms. In this study, we aimed to assess the influence of ESRD on PUB hospitalizations in the United States (US).

Methods: We utilized the National Inpatient Sample to identify all adult hospitalizations of PUB in the US between 2007–2014. The study population was subdivided based on the presence or absence of ESRD. Hospitalization characteristics and outcomes were compared. Predictors of inpatient mortality were also identified. P-values ≤0.05 were statistically significant.

Results: Between 2007–2014, there were 351,965 and 2,037,037 PUB hospitalizations with and without ESRD, respectively, in the US (Table 1). PUB hospitalizations with ESRD had a higher mean age (71.6 vs 63.6 years, p< 0.001), and proportion of males (55.5 vs 44.2%, p< 0.001) compared to non-ESRD PUB hospitalizations. Additionally, PUB hospitalization with ESRD had a higher proportion of ethnic minorities such as Blacks (20.2 vs 12.4%, p< 0.001), Hispanics (9.2 vs 8.5%, p< 0.001), and Asians (4.5 vs 3.3%, p< 0.001) compared to the non-ESRD PUB cohort. However, non-ESRD PUB hospitalizations had a higher proportion of Whites (72.2 vs 63.2%, p< 0.001) compared to the ESRD cohort. Interestingly, rates of H. Pylori infection were lower (3.8 vs 5.7%, p< 0.001) for PUB hospitalization with ESRD compared to the non-ESRD PUB cohort. Furthermore, we noted higher inpatient mortality (5.4% vs 2.6%, p< 0.001), mean length of stay [LOS] (8.2 vs. 6 days, p< 0.001), and rates of esophagogastroduodenoscopy (EGD) (20.9 vs 19.1%, p< 0.001) for PUB hospitalizations with ESRD compared to the non-ESRD PUB cohort. After multivariate logistic regression analysis, whites with ESRD had higher odds of inpatient mortality from PUB compared to other races. To our surprise, the odds of inpatient mortality from PUB decreased by 0.6% for every one-year increase in age for patients with ESRD. Compared to the 2011–2014 study period, the 2007–2010 period had 43.7% higher odds of inpatient mortality for PUB hospitalizations with ESRD.

Discussion: Despite accounting for only 1.7% of all PUB hospitalizations in the US, PUB hospitalizations with ESRD had higher inpatient mortality, mean LOS, and EGD utilization compared to the non-ESRD PUB cohort.



Disclosures:


Dushyant S. Dahiya, MD¹, Amandeep Singh, MD², Abhilash Perisetti, MD³, Priyata Dutta, MD⁴, Rajat Garg, MD², Sailaja Pisipati, MBBS, FRCS⁵, Chin-I Cheng, PhD⁶, Sumant Inamdar, MD, MPH⁷, Madhusudhan Sanaka, MD⁸, Mohammad Al-Haddad, MD, MSc⁹. B0683 - Peptic Ulcer Bleeding in End-Stage Renal Disease Hospitalizations: A Comparative Analysis in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.