Predictors of In-Hospital Mortality in Nonelderly Patients Admitted With Bleeding Gastritis: A Retrospective Cohort of 8,874 Patients

Author Type(s)

Faculty

Document Type

Abstract

Publication Date

11-2021

Journal Title

Journal of the American College of Surgeons

Department

Surgery

Abstract

Introduction

This study aimed to identify independent predictors of in-hospital mortality in nonelderly patients emergently admitted with bleeding gastritis.

Methods

A retrospective cohort study was conducted using the National Inpatient Sample (NIS) to identify nonelderly adult patients (ages 18-64-year-old) emergently admitted with a primary diagnosis of gastritis with hemorrhage between 2005-2014. Data on demographics, clinical course, and hospitalization were collected. Chi square and Student’s t-tests were used to compare categorical and continuous variables, respectively. Multivariable logistic regression analysis with backward elimination was performed to evaluate the associations between mortality and independent predictors.

Results

A total of 8,874 patients with a mean (SD) age of 47.07 (11.19) years were included. Of them, 33.3% were female. Precisely, 48.7% of patients had alcoholic gastritis, 32.6% acute, and 18.6% atrophic. The mortality rate was 0.7% (n=66). Mortality rate was not significantly associated with the type of gastritis (alcoholic, 0.8%; acute, 0.9%; atrophic, 0.4%; p=0.2). Gastritis-related procedure was observed in 53.9% of patients with alcoholic gastritis, 79.5% of acute, and 93.0% of atrophic (p<0.001). The mean (SD) hospital length of stay (HLOS) was 3.74 (4.05) days. Patients with atrophic gastritis had a significantly longer HLOS [3.99 (4.27)] than alcoholic [3.62 (4.29)] and acute [3.78 (3.52)] (p=0.006). In backward logistic regression, HLOS, age, congestive heart failure, coagulopathy, liver disease, fluid/electrolyte disorders, metastatic cancer, paralysis, and weight loss were significantly associated with mortality.

Conclusion

For nonelderly patients admitted with a primary diagnosis of bleeding gastritis, increased HLOS was associated with an increased in-hospital mortality rate.

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