S0637 Incidence and Mortality of Gastrointestinal Hemorrhage Based on Anatomic Location of Gastrointestinal Tumors

Abstract

INTRODUCTION: Gastrointestinal Hemorrhage (GIH) is common in patients with gastrointestinal tumors (GIT). Some literature studied the prevalence of GIT in GIH, but no previous research was inclusive for the incidence and mortality of GIH in all types of GIT. We aimed to study the incidence and mortality of GIH based on the anatomic location of GIT. METHODS: This was a retrospective cohort review of the 2016 National Inpatient Sample (NIS) database, which is the largest national inpatient database. NIS is drawn from all states and covers more than 97% of the U.S. population. Adult patients with age of 18 years or more were included in the analysis. ICD-10 CM codes were used to identify patients with GIH and GIT based on their anatomical location and primary or secondary status. Secondary GIT is defined as a metastatic tumor in the GI tract. Frequencies were presented in percentages. RESULTS: Out of more than 6 million hospitalizations studied, 145,624 cases (2.4%) had a diagnosis of GIT. Patients with GIT had significantly higher rates of GIH compared to patients without GIT (8.0% vs. 3.3%, P < 0.001). Incidence and mortality of GIH (Figure 1) in patients with primary GIT, respectively, are 9.5% and 9.7% in all primary tumors, 8.7% and 14.4% in esophageal, 15.2% and 7.5% in stomach, 12.1% and 6.4% in small bowel, 8.7% and 6.7% in colorectal, 12.1% and 17.7% in liver tumors, 6.3% and 15.5% in biliary, and 6.6% and 6.6% in others. Incidence and mortality of GIH in patients with secondary GIT are 6.6% and 15.2% in all secondary GIT, 11.8% and 10.9% in small bowel, 8.9%, and 12.2% in colorectal, 6.7% and 16.4% in liver, and 6.2% and 15.8% in others. CONCLUSION: GIT have a higher incidence of GIH compared to the general inpatient population. The most frequently bleeding primary GIT are gastric, small bowel, and liver tumors. The most frequently bleeding secondary GIT are small bowel, colorectal, and liver tumors. The highest mortality of hemorrhage appears to be in hepatobiliary tumors. Future studies should investigate the multifactorial relationship between GIH and GIT.Figure 1.: Histogram showing inpatient incidence and mortality of GIH based on the anatomic location of GIT.