HIV Infection: Does It Affect Outcomes of Gastrointestinal Bleeding?

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Introduction: Gastrointestinal (GI) bleeding is a relatively infrequent complication seen in patients with HIV infection. Beyond the traditional risk factors associated with HIV infection, bleeding may result from conditions completely unrelated. The effect of HIV infection in outcomes of GI bleeding is currently unknown. We sought to evaluate contemporary outcomes and complications of GI bleeding in patients with co-morbid HIV infection. Methods: The study population was derived from the HCUP- National Inpatient Sampling database for the years 2007-2013. ICD-9 codes were used to identify patients with GI bleeding. In-hospital all-cause mortality, total cost of hospitalization, mean length of stay and outcomes rates were assessed. Propensity score matching was used to adjust for baseline confounders. Results: Among 5,850,728 admissions with GI bleeding during the study period, 46,683 (0.8%) had a history of comorbid HIV infection. HIV patients were more likely to be younger, male, with a history of hepatitis, alcohol related disorder, chronic renal failure, pancreatic disease, liver and biliary disease and coagulation and hemorrhagic disorders (P<0.0001). In hospital all-cause mortality, length of stay, cost of hospitalization and rates of acute kidney injury, acute stroke and blood transfusions were significantly higher in the HIV patient cohort. These statistically significant differences persisted after propensity score matching analysis. (Figure 1). Conclusion: Co-morbid HIV infection is associated with increased in hospital all-cause mortality, length of stay, cost of hospitalization and rates of acute kidney injury, acute stroke and blood transfusions in patients presenting with GI bleeding.Table: Baseline characteristics and outcomes.