Original articleTrends in Management and Outcomes of Acute Nonvariceal Upper Gastrointestinal Bleeding: 1993–2003
Section snippets
Description of Data Sets
The data used in our study were obtained from Statistics Canada’s Health Person-Oriented Information Database (HPOID). The HPOID contains information on hospital separations (discharges or deaths) from nearly all acute-care medical facilities across Canada. Each record contains demographic and administrative data, primary admitting diagnoses, up to 24 additional secondary diagnoses, and up to 20 surgical procedures. Endoscopic procedures are not routinely included. The data are based on the
Incidence of Acute Nonvariceal Upper-Gastrointestinal Bleeding
The total eligible population and the number of patients with ANVUGIB identified using each of the case-finding definitions are displayed in Table 1, and the incidence rates for ANVUGIB are shown in Figure 1 (overall) and Figure 2 (stratified by age). By using the more strict diagnostic administrative definition of ANVUGIB, the incidence of ANVUGIB has decreased significantly from 52.4 patients/100,000 person-years in 1993–1994 to 34.3 per 100,000 person-years in 2002–2003 (B = −1.92
Discussion
Our findings suggest that ANVUGIB incidence steadily decreased from 1993 until the year 2000, after which the incidence rate of ANVUGIB remained steady. Furthermore, the mortality rate of patients with a primary diagnosis of ANVUGIB was much lower than has been quoted commonly in the medical literature.1, 2, 3, 6, 7 However, the mortality rate associated with ANVUGIB did not significantly change over the 10-year study period. We did see decreases in the mean LOHS of ANVUGIB patients, with the
References (40)
Etiology and prevalence of severe persistent upper gastrointestinal bleeding
Gastroenterology
(1983)- et al.
Hospitalization and mortality rates from peptic ulcer disease and GI bleeding in the 1990s: relationship to sales of nonsteroidal anti-inflammatory drugs and acid suppression medications
Am J Gastroenterol
(2002) - et al.
Endoscopic therapy for acute nonvariceal upper gastrointestinal hemorrhage: a meta-analysis
Gastroenterology
(1992) - et al.
Ecological measures of socioeconomic status and hospital readmissions for asthma among Canadian adults
Respir Med
(2004) - et al.
The accuracy of diagnosis and procedural codes for patients with upper GI hemorrhage
Gastrointest Endosc
(2000) Recent developments in the epidemiology of Helicobacter pylori
Gastroenterol Clin North Am
(2000)- et al.
Omeprazole as adjuvant therapy to endoscopic combination injection sclerotherapy for treating bleeding peptic ulcer
Am J Med
(2001) - et al.
Gastrointestinal bleeding in the hospitalized patient: a case-control study to assess risk factors, causes, and outcome
Am J Med
(1998) - et al.
Endoscopy-based triage significantly reduces hospitalization rates and costs of treating upper GI bleeding
Gastrointest Endosc
(1999) - et al.
Managing patients with acute, nonvariceal gastrointestinal hemorrhage: development and effectiveness of a clinical care pathway
Am J Gastroenterol
(2001)
Positive predictive value of ICD-9th codes for upper gastrointestinal bleeding and perforation in the Sistema Informativo Sanitario Regionale database
J Clin Epidemiol
Urgent vs. elective endoscopy for acute non-variceal upper-GI bleeding: an effectiveness study
Gastrointest Endosc
Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom
BMJ
Acute upper gastrointestinal bleeding in the Amsterdam area: incidence, diagnosis, and clinical outcome
Am J Gastroenterol
Epidemiology of hospitalization for acute upper gastrointestinal hemorrhage: a population-based study
Am J Gastroenterol
Risk of persistent or recurrent and intractable upper gastrointestinal bleeding in the era of therapeutic endoscopy
Am J Gastroenterol
The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting
Am J Gastroenterol
The epidemiology of hemorrhage from the upper gastrointestinal tract in the mid-nineties—has anything changed?
Hepatogastroenterology
Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers
N Engl J Med
Meta-analysis: proton-pump inhibition in high-risk patients with acute peptic ulcer bleeding
Aliment Pharmacol Ther
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Supported by the Rudy Falk Clinician Scientist Award (L.E.T.).