2898 Factors Influencing the Length of Hospital Stay in Patients With Non-Variceal Upper Gastrointestinal Bleeding

Abstract

INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is one of the most common GIemergencies, which frequently requires hospitalization. This condition accounts for 400,000 hospital admissions per year and costs more than $2 billion annually. The purpose of our study was to identify risk factors associated with prolonged hospital stay in non-variceal UGIB patients. METHODS: We conducted a retrospective study through an electronic medical record review of patients admitted at University Medical Center, Lubbock, Texas between January 2012 and December 2015. Patients older than 18 years with UGIB identified by the ICD-9 diagnosis code 578.9 (hemorrhage of gastrointestinal tract, unspecified) were enrolled into the study. Admissions were excluded if patients did not undergo EGD or if they had documented underlying cirrhosis. Statistical Package for Social Sciences (SPSS™) version 22 was used for statistical analysis. RESULTS: 143 patients met inclusion criteria. 83 were men (58.0%), 92 were Caucasian (64.3%), 33 were Hispanic (22.4%), and the mean age was 60.9 + 17.1 years. 33% of patients requiring FFP transfusion underwent endoscopic therapy. The mean length of stay (LOS) was significantly increased in patients requiring endoscopic therapy, FFP transfusion, and inthose who had underwent EGD after 24 hours. LOS was also significantly increased in patients that presented with acute kidney injury (AKI) or hypoalbuminemia. There was no correlation between prolonged hospital stay and Glasgow-Blatchford bleeding score, pre-endoscopic Rockall score, Rockall score, AIMS65 score, shock index score, PRBC transfusion, the use of NSAIDs, antiplatelet drugs, or anticoagulants. CONCLUSION: Our study demonstrates that delayed EGD (after 24 hours), endoscopic therapy, the need for FFP transfusion, and acute kidney injury are associated with prolonged hospital stay. Coagulopathy requiring FFP transfusion and AKI reflects the severity of UGIB. Urgent EGD and endoscopic intervention in these patients may decrease the LOS and improve outcomes.