Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 14, Number 2, April 2021, pages 104-111

Gastric Antral Vascular Ectasia: Trends of Hospitalizations, Biodemographic Characteristics, and Outcomes With Watermelon Stomach

Figure 1. Sequential derivation of the study population for GAVE hospitalizations from 2001 to 2011. GAVE: gastric antral vascular ectasia; ICD-9-CM: International Classification of Diseases, Ninth Revision, Clinical Modification.

Figure 2. Description of characteristics of GAVE hospitalizations. (a) Total number of discharges with GAVE. (b) Gender distribution for GAVE hospitalizations. (c) Inpatient mortality for GAVE hospitalizations. (d) Cost of care for GAVE hospitalizations. GAVE: gastric antral vascular ectasia.

**Table 1.** Baseline Characteristics of Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2001 to 2011
	2001	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	P value
Number of hospitalizations	25,423	27,218	28,978	32,799	33,724	32,773	33,669	39,278	41,390	42,036	44,787	< 0.0001
With hemorrhage	19,168	20,115	21,594	24,616	25,619	23,032	23,505	26,587	26,581	26,872	27,679	< 0.0001
Without hemorrhage	6,255	7,103	7,384	8,183	8,105	9,742	10,165	12,690	14,809	15,164	17,108	< 0.0001
Age in years (%)
18 - 34	0.54	0.59	0.5	0.5	0.49	0.51	0.5	0.67	0.57	0.66	0.72	< 0.0001
35 - 49	3.08	3.33	2.81	3.34	2.94	3.4	3.01	2.98	3.47	3.3	3.18	0.035
50 - 64	11.19	12.28	12.78	12.78	14.03	14.05	14.58	15.8	16.11	18.24	17.64	< 0.0001
65 - 79	44.99	46.23	47.01	45.69	44.89	44.14	44.08	42.33	43.29	42.3	41.7	< 0.0001
≥ 80	40.03	37.52	36.83	37.66	37.56	37.85	37.8	38.17	36.49	35.45	36.71	< 0.0001
Gender (%)
Male	43.1	42.22	41.68	43.17	42.21	43.19	45.14	43.75	44.35	45.8	44	< 0.0001
Female	56.9	57.78	58.32	56.82	57.78	56.81	54.83	56.25	55.64	54.18	55.99
Race (%)
White	58.19	54.46	54.31	56.7	58.81	57.67	52.88	59.97	62.66	64.57	65.92	< 0.0001
Black	10.86	11.67	13.21	12.72	9.65	11.7	12.61	12.57	12.8	15.41	14.47	< 0.0001
Hispanic	5.38	5.9	6.52	4.71	4.67	6.62	5.4	5.86	7.1	7.36	7.58	< 0.0001
Others	1.98	2.47	2.32	2.14	2.32	2.77	2.54	3.08	3.31	3	2.92	< 0.0001
Hospital region (%)
Northeast	21.55	22.55	21.34	21.62	21.88	22.29	18.95	20.38	21.1	20.64	20.11	< 0.0001
Midwest	23.14	22.18	25.86	23.75	22.75	24.27	26.98	24.46	25.33	25.61	25.35	< 0.0001
South	40.95	37.37	38.35	40.14	39.39	36.97	39.47	40.83	39.1	39.51	40.12	0.0002
West	14.36	17.89	14.45	14.49	15.98	16.47	14.61	14.33	14.48	14.24	14.42	< 0.0001
Hospital location (%)
Rural	9.99	10.74	12.13	7.93	8.63	7.33	8.77	7.97	7.39	8.59	7.07	< 0.0001
Urban nonteaching	48.94	49.47	45.97	51.83	55.34	49.7	49.34	49.9	47.75	47.68	46.01	< 0.0001
Urban teaching	41.06	39.79	41.87	40.23	36.03	42.6	41.52	42.13	43.63	42.96	46.24	< 0.0001
Median household income (%)
Quartile 1	7.72	5.05	28.17	26.95	26.25	25.98	28.29	27.03	27.28	28	29.1	< 0.0001
Quartile 2	23.74	19.6	26.08	26.14	25.13	24.83	24.96	28.71	25.8	26.29	23.74	< 0.0001
Quartile 3	27	24.42	24.68	22.62	25.79	23.99	23.56	21.89	24.26	23.66	25.67	< 0.0001
Quartile 4	40.47	48.64	19.1	22.59	21.31	23.42	21.37	20.94	20.75	20.02	19.9	< 0.0001
Mode of payment (%)
Medicare	81.85	81.19	82.88	81.3	81.72	81.43	80.74	77.62	77.65	77.56	79.09	< 0.0001
Medicaid	3.44	4.1	4.04	3.71	3.7	3.91	3.46	4.11	4.76	5.33	4.65	< 0.0001
Private insurance	12.25	12.58	10.66	12.68	12.15	11.85	13.33	15.31	14.27	14.01	13.07	< 0.0001
Others (includes self-pay)	2.37	2.09	2.28	2.24	2.4	2.64	2.4	2.92	3.09	2.97	2.87	< 0.0001
Admission day (%)												0.002
Weekday	81.38	80.44	81.07	81.14	80.38	81.23	80.6	80.18	80.62	81.11	80.15
Weekend	18.62	19.56	18.93	18.86	19.62	18.77	19.4	19.82	19.38	18.89	19.85
Inpatient mortality (%)	2.2	2.16	1.99	1.85	1.92	1.6	1.75	1.8	1.76	1.85	1.73	< 0.0001
Cost of care ($)	11,590	12,394	11,636	12,190	12,313	12,609	12,012	12,179	12,659	13,724	12,930	< 0.0001

Table 1. Baseline Characteristics of Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2001 to 2011

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

P value

Number of hospitalizations

25,423

27,218

28,978

32,799

33,724

32,773

33,669

39,278

41,390

42,036

44,787

< 0.0001

With hemorrhage

19,168

20,115

21,594

24,616

25,619

23,032

23,505

26,587

26,581

26,872

27,679

< 0.0001

Without hemorrhage

6,255

7,103

7,384

8,183

8,105

9,742

10,165

12,690

14,809

15,164

17,108

< 0.0001

Age in years (%)

18 - 34

0.54

0.59

0.5

0.49

0.51

0.5

0.67

0.57

0.66

0.72

< 0.0001

35 - 49

3.08

3.33

2.81

3.34

2.94

3.4

3.01

2.98

3.47

3.3

3.18

0.035

50 - 64

11.19

12.28

12.78

14.03

14.05

14.58

15.8

16.11

18.24

17.64

< 0.0001

65 - 79

44.99

46.23

47.01

45.69

44.89

44.14

44.08

42.33

43.29

42.3

41.7

< 0.0001

≥ 80

40.03

37.52

36.83

37.66

37.56

37.85

37.8

38.17

36.49

35.45

36.71

< 0.0001

Gender (%)

Male

43.1

42.22

41.68

43.17

42.21

43.19

45.14

43.75

44.35

45.8

< 0.0001

Female

56.9

57.78

58.32

56.82

57.78

56.81

54.83

56.25

55.64

54.18

55.99

Race (%)

White

58.19

54.46

54.31

56.7

58.81

57.67

52.88

59.97

62.66

64.57

65.92

< 0.0001

Black

10.86

11.67

13.21

12.72

9.65

11.7

12.61

12.57

12.8

15.41

14.47

< 0.0001

Hispanic

5.38

5.9

6.52

4.71

4.67

6.62

5.4

5.86

7.1

7.36

7.58

< 0.0001

Others

1.98

2.47

2.32

2.14

2.32

2.77

2.54

3.08

3.31

2.92

< 0.0001

Hospital region (%)

Northeast

21.55

22.55

21.34

21.62

21.88

22.29

18.95

20.38

21.1

20.64

20.11

< 0.0001

Midwest

23.14

22.18

25.86

23.75

22.75

24.27

26.98

24.46

25.33

25.61

25.35

< 0.0001

South

40.95

37.37

38.35

40.14

39.39

36.97

39.47

40.83

39.1

39.51

40.12

0.0002

West

14.36

17.89

14.45

14.49

15.98

16.47

14.61

14.33

14.48

14.24

14.42

< 0.0001

Hospital location (%)

Rural

9.99

10.74

12.13

7.93

8.63

7.33

8.77

7.97

7.39

8.59

7.07

< 0.0001

Urban nonteaching

48.94

49.47

45.97

51.83

55.34

49.7

49.34

49.9

47.75

47.68

46.01

< 0.0001

Urban teaching

41.06

39.79

41.87

40.23

36.03

42.6

41.52

42.13

43.63

42.96

46.24

< 0.0001

Median household income (%)

Quartile 1

7.72

5.05

28.17

26.95

26.25

25.98

28.29

27.03

27.28

29.1

< 0.0001

Quartile 2

23.74

19.6

26.08

26.14

25.13

24.83

24.96

28.71

25.8

26.29

23.74

< 0.0001

Quartile 3

24.42

24.68

22.62

25.79

23.99

23.56

21.89

24.26

23.66

25.67

< 0.0001

Quartile 4

40.47

48.64

19.1

22.59

21.31

23.42

21.37

20.94

20.75

20.02

19.9

< 0.0001

Mode of payment (%)

Medicare

81.85

81.19

82.88

81.3

81.72

81.43

80.74

77.62

77.65

77.56

79.09

< 0.0001

Medicaid

3.44

4.1

4.04

3.71

3.7

3.91

3.46

4.11

4.76

5.33

4.65

< 0.0001

Private insurance

12.25

12.58

10.66

12.68

12.15

11.85

13.33

15.31

14.27

14.01

13.07

< 0.0001

Others (includes self-pay)

2.37

2.09

2.28

2.24

2.4

2.64

2.4

2.92

3.09

2.97

2.87

< 0.0001

Admission day (%)

0.002

Weekday

81.38

80.44

81.07

81.14

80.38

81.23

80.6

80.18

80.62

81.11

80.15

Weekend

18.62

19.56

18.93

18.86

19.62

18.77

19.4

19.82

19.38

18.89

19.85

Inpatient mortality (%)

2.2

2.16

1.99

1.85

1.92

1.6

1.75

1.8

1.76

1.85

1.73

< 0.0001

Cost of care ($)

11,590

12,394

11,636

12,190

12,313

12,609

12,012

12,179

12,659

13,724

12,930

< 0.0001

**Table 2.** Comorbidities Associated With Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2002 to 2011
AHRQ comorbidity measures (%)	2002	2003	2004	2005	2006	2007	2008	2009	2010	2011	P value
AHRQ: Agency for Healthcare Research and Quality.
Obesity	2.03	2.45	2.83	3.42	3.75	4.59	5.5	7.08	7.76	9.44	< 0.0001
Hypertension	39.6	49.33	54.58	53.61	59.96	61.69	61.86	65.38	66.76	69.6	< 0.0001
Diabetes mellitus	26.73	27.68	27.36	29.12	31.08	32.48	33.3	34.22	35.38	36.63	< 0.0001
Congestive heart failure	21.76	22.8	24.29	25.46	24.85	25.54	23.35	24.38	24.35	25.44	0.0002
Chronic obstructive pulmonary disease	26.64	28.03	29.4	30.06	32.1	31.75	28.17	29.67	30.27	30.68	< 0.0001
Peripheral vascular disease	8.23	8.68	9.47	9.85	10.17	11.93	13.1	13.27	14.11	14.74	< 0.0001
Renal failure	24.31	26.16	28.97	31.9	38.97	42.36	42	46.32	47.88	50.87	< 0.0001
Neurological disorders	7.02	6.08	7.16	6.36	7.32	8.18	9.07	9.34	9.21	10.38	< 0.0001
Anemia	24.9	26.4	26.92	28.78	30.66	30.94	34.18	35.75	36.42	38.96	< 0.0001
Solid tumor without metastasis	9.63	2.04	2.2	1.94	2.13	2.65	2.35	2.63	2.72	3.05	< 0.0001
Weight loss	2.33	2.36	2.94	3.42	4.27	3.68	4.92	5.35	7.17	7.96	< 0.0001
Rheumatic disorders	2.66	2.64	3.39	3.41	3.84	4.2	3.89	4.64	4.31	4.62	< 0.0001
Psychiatric disorders	6.24	6.6	7.07	8.3	9.95	9.75	11.69	12.17	13.21	15.74	< 0.0001
Liver disease	6.2	6.7	7.04	7.19	7.35	8.03	9.5	10.72	12.04	13.37	< 0.0001

Table 2. Comorbidities Associated With Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2002 to 2011

AHRQ comorbidity measures (%)

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

P value

AHRQ: Agency for Healthcare Research and Quality.

Obesity

2.03

2.45

2.83

3.42

3.75

4.59

5.5

7.08

7.76

9.44

< 0.0001

Hypertension

39.6

49.33

54.58

53.61

59.96

61.69

61.86

65.38

66.76

69.6

< 0.0001

Diabetes mellitus

26.73

27.68

27.36

29.12

31.08

32.48

33.3

34.22

35.38

36.63

< 0.0001

Congestive heart failure

21.76

22.8

24.29

25.46

24.85

25.54

23.35

24.38

24.35

25.44

0.0002

Chronic obstructive pulmonary disease

26.64

28.03

29.4

30.06

32.1

31.75

28.17

29.67

30.27

30.68

< 0.0001

Peripheral vascular disease

8.23

8.68

9.47

9.85

10.17

11.93

13.1

13.27

14.11

14.74

< 0.0001

Renal failure

24.31

26.16

28.97

31.9

38.97

42.36

46.32

47.88

50.87

< 0.0001

Neurological disorders

7.02

6.08

7.16

6.36

7.32

8.18

9.07

9.34

9.21

10.38

< 0.0001

Anemia

24.9

26.4

26.92

28.78

30.66

30.94

34.18

35.75

36.42

38.96

< 0.0001

Solid tumor without metastasis

9.63

2.04

2.2

1.94

2.13

2.65

2.35

2.63

2.72

3.05

< 0.0001

Weight loss

2.33

2.36

2.94

3.42

4.27

3.68

4.92

5.35

7.17

7.96

< 0.0001

Rheumatic disorders

2.66

2.64

3.39

3.41

3.84

4.2

3.89

4.64

4.31

4.62

< 0.0001

Psychiatric disorders

6.24

6.6

7.07

8.3

9.95

9.75

11.69

12.17

13.21

15.74

< 0.0001

Liver disease

6.2

6.7

7.04

7.19

7.35

8.03

9.5

10.72

12.04

13.37

< 0.0001

**Table 3.** Predictors of Mortality for Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2001 to 2011
Characteristics	Odds ratio	95% confidence interval	P value
HMO: Health Maintenance Organization.
Hemorrhage	1.27	1.10 - 1.46	0.001
Elixhauser comorbidity index (every 1-point increase)	1.18	1.14 - 1. 22	< 0.0001
Age (years)
18 - 44	Reference
45 - 64	1.05	0.62 - 1.78	0.84
65 - 84	1.17	0.69 - 1.97	0.57
≥ 85	1.46	0.85 - 2.50	0.17
Gender
Male	Reference
Female	0.841	0.745 - 0.951	0.0055
Race
White	Reference
Black	0.88	0.73 - 1.06	0.17
Hispanic	1.25	1.01 - 1.55	0.04
Others	1.30	0.96 - 1.75	0.09
Hospital bed size
Small	0.92	0.75 - 1.13	0.44
Medium	0.93	0.81 - 1.08	0.35
Large	Reference
Hospital region
Northeast	Reference
Midwest	0.89	0.73 - 1.08	0.22
South	0.99	0.84 - 1.16	0.91
West	1.06	0.88 - 1.28	0.55
Hospital type (%)
Rural	0.82	0.62 - 1.07	0.15
Urban nonteaching	0.89	0.78 - 1.01	0.07
Teaching	Reference
Primary insurance (%)
Medicare/Medicaid	Reference
Private including HMO	0.92	0.74 - 1.16	0.49
Uninsured/self-pay	0.93	0.60 - 1.46	0.76

Table 3. Predictors of Mortality for Gastric Antral Vascular Ectasia (GAVE) Hospitalizations From 2001 to 2011

Characteristics

Odds ratio

95% confidence interval

P value

HMO: Health Maintenance Organization.

Hemorrhage

1.27

1.10 - 1.46

0.001

Elixhauser comorbidity index (every 1-point increase)

1.18

1.14 - 1. 22

< 0.0001

Age (years)

18 - 44

Reference

45 - 64

1.05

0.62 - 1.78

0.84

65 - 84

1.17

0.69 - 1.97

0.57

≥ 85

1.46

0.85 - 2.50

0.17

Gender

Male

Reference

Female

0.841

0.745 - 0.951

0.0055

Race

White

Reference

Black

0.88

0.73 - 1.06

0.17

Hispanic

1.25

1.01 - 1.55

0.04

Others

1.30

0.96 - 1.75

0.09

Hospital bed size

Small

0.92

0.75 - 1.13

0.44

Medium

0.93

0.81 - 1.08

0.35

Large

Reference

Hospital region

Northeast

Reference

Midwest

0.89

0.73 - 1.08

0.22

South

0.99

0.84 - 1.16

0.91

West

1.06

0.88 - 1.28

0.55

Hospital type (%)

Rural

0.82

0.62 - 1.07

0.15

Urban nonteaching

0.89

0.78 - 1.01

0.07

Teaching

Reference

Primary insurance (%)

Medicare/Medicaid

Reference

Private including HMO

0.92

0.74 - 1.16

0.49

Uninsured/self-pay

0.93

0.60 - 1.46

0.76