The impact of endoscopy and specialist care on 30-day mortality among patients with acute non-variceal upper gastrointestinal hemorrhage: an Italian population-based study

Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Anna KohnSEID Appropriateness Working Group

Abstract

To analyze the effects of endoscopy and care in a gastroenterology ward on 30-day mortality among Italian patients hospitalized for acute non-variceal upper gastrointestinal hemorrhage (UGIH). We conducted a population-based study based on administrative data contained in the Regional Hospital Information System (RHIS) for the Lazio Region (Italy). We identified all hospitalizations with a main diagnosis of UGIH during period 2000-2005. Discharge data were analyzed for procedures performed, ward where the patient was cared for, comorbidities, vital status at discharge. Vital status 30 days after admission was cross-checked with the Regional Registry of Causes of Death. Logistic regression models were performed taking into account patients' risk factors (OR and C.I. 95%). A total of 13,427 hospitalizations for UGIH (mean patient age, 68 years; 60% males) were identified. The 30-day mortality was 6.9%. Significantly lower rates were observed among hospitalizations that included endoscopy (OR 0.30, 95% C.I. 0.26-0.34), specialist care (OR 0.55, 95% C.I. 0.37-0.82), or both (OR 0.12, 95% C.I. 0.07-0.22). The protective effects of endoscopy and specialist care remained strong after adjustment for potential risk factors. Endoscopy, p...Continue Reading

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Citations

Dec 25, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Lucas G CavallaroMario Saia
Dec 24, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Gianluca RotondanoUNKNOWN PNED (Progetto Nazionale Emorragie Digestive) Investigators
Dec 3, 2014·Gastroenterology Clinics of North America·Gianluca Rotondano
Nov 14, 2013·Gastrointestinal Endoscopy·Riccardo MarmoUNKNOWN PNED 1 and PNED 2 Investigators
Feb 28, 2016·Digestive Diseases and Sciences·Sejin HwangUNKNOWN Daegu-Gyengbuk Gastrointestinal Study Group (DGSG)
Jul 1, 2015·Frontline Gastroenterology·Nivedita Ghosh, Purushothaman Premchand

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