Predictors of Blood Transfusion in Hospitalized Gastric Antral Vascular Ectasia (GAVE) Patients

Abstract

Introduction: Gastric antral vascular ectasia (GAVE) is an uncommon condition causing chronic upper gastrointestinal bleeding which often necessitates blood transfusions during the hospitalizations. Considering a paucity of the data, we sought to explore the predictors of blood transfusions in the GAVE patients using the largest nationwide cluster. Methods: We queried the National Inpatient Sample (NIS) (2010—2014) using International Classification of Diseases, 9th Revision (ICD—9) codes (537.82, 537.83) to identify GAVE patients. The recipients of blood transfusions in the GAVE cohorts were identified using Clinical Classifications Software (CCS) code (222). The predictors of blood transfusion in GAVE cohorts were analyzed using multivariate logistic regression by SPSS Statistics 22.0.1202 Figure 1 No Caption available.Results: A total of 17,982 (weighted 89,081) GAVE patients were identified from the database. A total of 6,276 (weighted 31,102) (34.9%) of these patients received at least a single blood transfusion during that hospitalization. Advanced age (OR1.81, CI 1.77—1.85, p<0.001), male gender (OR1.06, CI 1.03—1.10, p<0.001), African American race (OR1.18, CI 1.12—1.23, p<0.001), higher household income (76—100th percentile; OR1.09, CI 1.04—1.15, p<0.001), weekday (OR1.11, CI 1.07—1.16, p<0.001) and non—elective admissions (OR 1.52, CI 1.44—1.60, p<0.001) and Medicare payer status (OR1.65, CI 1.45—1.88, p<0.001) notably increased the odds of blood transfusion in the GAVE patients. The odds of blood transfusions were higher in the patients hospitalized at the urban nonteaching (OR1.21, CI 1.17—1.25, p<0.001), non—profit private (OR1.22, CI 1.16—1.28, p<0.001) and Southern (OR1.06, CI 1.01—1.11, p=0.024) region hospitals. Comorbidities like H. pylori infection (OR1.93, CI 1.56—2.38, p<0.001), hemodialysis (OR1.79, CI 1.65—1.95, p<0.001), liver disease (OR1.75, CI 1.63—1.88, p<0.001), coagulopathy (OR1.75, CI 1.65—1.85, p<0.001), portal hypertension (OR1.44, CI 1.30—1.59, p<0.001) and congestive heart failure (OR1.40, CI 1.34—1.46, p<0.001) were key independent predictors of blood transfusion in GAVE patients (Table 1). Conclusion: We revealed that almost 35% of the GAVE patients received at least a single blood transfusion during their hospitalization. Results of the study will help the healthcare practitioners in recognizing the GAVE patients who are at higher risk of the need for blood transfusions so that prophylactic measures can be undertaken to avoid the same.