Temporal Trends and Demographic Variations in Incidence of Angiodysplasia of the Intestines: A U.S. Population Based Study

Abstract

Introduction: The terms angiodysplasia, arteriovenous malformation, and vascular ectasia have been synonymously used to describe the most common vascular anomalies of the GI tract. Limited epidemiological data exists on the annual number of hospitalisations and patient characteristics for angiodysplasia of the intestines. We wanted to determine national inpatient admission trends and demographic variation in patients with discharge diagnoses of angiodysplasia of the intestines. Methods: We analysed the National Inpatient Sample (NIS) database for all subjects with discharge diagnosis of angiodysplasia of the intestines with or without hemorrhage (ICD-9 code 569.85 and 569.84 respectively) as principal and/or secondary diagnosis during the period from 2000-2010. NIS is the largest publicly available all-payer inpatient care database in the United States. It contains data from approximately 8 million hospital stays each year. Statistical significance of variation in the number of hospital discharges and demographics including age, race, and gender differences during the study period was determined by using p-trends. All admissions with angiodysplasia of the intestines as diagnosis were considered. Results: In 2000, there were 37,322 admissions with discharge diagnosis of angiodysplasia of the intestines as compared to 38,827 in 2010 (p = 0.245, Figure 1). Without hemorrhage, the total number of admissions in 2000 was 11,751 whereas in 2010 was 15,668 (p=0.001, Figure 1). With hemorrhage, the total number of admissions in 2000 was 25,571 whereas in 2010 was 23,159 (p=0.082, Figure 1). Angiodysplasia of intestines was found to be most common in the age group 65-79 years (p < 0.001,Figure 2) followed by age group >80 years (p=0.002,Figure 2). We also found a female preponderance, the trend of which showed slight decline from 2000 to 2011 (p < 0.001,Figure 3). Additionally, from 2000 to 2011, racial predilection was evident with white race being at highest risk for angiodyplasia of the intestines (p < 0.001,Figure 3).Figure 1Figure 2Figure 3Conclusion: Although there has not been a significant rise in the total number of hospitalisations with angiodysplasia of the intestines; there has been a significant increase in the proportion of admissions associated without hemorrhage. Female gender, age group 65-79 and white race were found to have significantly higher admission rates than all other groups. More studies are required to identify additional risk factors and possibly explain these findings.