PB0477 - Age and sex distribution of the prevalence and incidence of hospitalisations and mortality due to bleeding in England 2014-2019

Background: The relationship between age, sex and acute bleeding is described but not well defined in a national cohort. Studies evaluating demographics with respect to burden, incidence and trends in bleeding hospitalisations and mortality are infrequent.

Aims: To report the age and sex distribution of bleeding-related hospitalisations and mortality.

Methods: A population-based review of people in England between 2014 and 2019 either admitted to an acute care ward, or who died was undertaken. Admitted patients were identified using the Hospital Episode Statistic database. Mortality data and population estimates were obtained from the Office of National Statistics. Bleeding events were selected based on the International Statistical Classification of Diseases version 10 codes. Patients with inherited or acquired coagulation or platelet disorders, and those who were not admitted (emergency department or outpatient clinic) were excluded. Analyses were stratified by year, sex and age. Annual incidence of admissions was calculated per 100,000 patient years, and deaths per 100,000 people.

Results: There was a total of 3,238,427 hospitalisations, with a mean of 539,738 ± 6033 per year and 81,264 deaths with a mean of 13,544 ± 331 per year attributable to bleeding. The mean annual incident rate for bleeding related hospitalisations was 975 per 100,000 patient years and for mortality was 24.45. 58.9% (n=1,908,153) of all hospitalisations occurred in females. Males had a higher mean annual mortality (OR 1.06, p < 0.001). Over the study period there was a trend of fewer deaths (χ2 test for trend 91.4, p< 0.001) (Figure 1). 68.6% (n= 55,786) of all deaths occurred in patients ≥ 75 years (Figure 2).

Conclusion(s): Females had a higher mean annual incidence of hospitalisation. Males had a higher annual incident mortality. The was a direct relationship between increasing age and incidence of bleeding related hospitalisation and mortality. The reasons for this require further investigation.