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 5, October 2021, pages 268-274

Outcomes of Non-Variceal Upper Gastrointestinal Bleed Stratified by Hospital Teaching Status: Insights From the National Inpatient Sample

**Table 1.** Patient and Hospital Characteristics of Hospitalizations With NVUGIB by Hospital Setting
Variable	Non-teaching hospital, %	Teaching hospital, %	P-value
^aFor 2017. NVUGIB: non-variceal upper gastrointestinal bleeding; SE: standard error of the mean; HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome.
N = 94,900	n = 34,725 (36.6%)	n = 60,175 (63.4%)
Patient characteristics
Age, years, mean ± SE	64.8 ± 0.5	62.8 ± 0.4	< 0.001
18 - 44 years	14.4	16.5
45 - 64 years	30.5	34.1
> 64 years	55.1	49.4
Women	40.3	37.7	< 0.001
Racial distribution			< 0.001
White	72.9	64.4
Black	9.3	14.7
Hispanic	9.0	11.1
Others	8.8	9.8
Charlson Comorbidity Index score			<0.001
0	19.1	19.2
1	25.5	23.2
2	17.4	16.2
≥ 3	38.0	41.4
Primary payer			< 0.001
Medicare	62.1	55.9
Medicaid	14.2	16.6
Private	18.1	21.5
Uninsured	5.6	6.0
Median annual income in patient’s zip code, US$^a			< 0.001
1 - 43,999	32.3	30.0
44,000 - 55,999	29.3	24.8
56,000 - 73,999	22.2	24.5
≥ 74,000	16.2	20.7
Comorbidities
Myocardial infarction	8.7	9.1	0.390
Congestive heart failure	15.1	16.7	0.004
Peripheral vascular disease	8.5	8.8	0.488
Cerebrovascular disease	4.7	5.1	0.205
Dementia	9.3	7.5	< 0.001
Chronic pulmonary disease	21.3	19.6	0.007
Rheumatologic disease	3.1	2.8	0.384
Peptic ulcer disease	28.6	26.7	0.009
Mild liver disease	8.2	9.7	< 0.001
Diabetes without complications	16.5	15.1	0.014
Diabetes with complications	10.4	12.1	0.001
Hemiplegia/paraplegia	0.8	1.1	0.118
Renal disease	20.3	22.4	0.001
Any malignancy	3.6	3.9	0.482
Moderate or severe liver disease	7.4	9.5	< 0.001
Metastatic solid tumor	2.0	2.5	0.036
HIV/AIDS	0.2	0.5	0.009
Hospital characteristics
Hospital region			< 0.001
Northeast	11.7	20.3
Midwest	19.7	21.6
South	42.4	36.3
West	26.2	21.8
Hospital bed size			< 0.001
Small	12.8	23.0
Medium	28.9	32.5
Large	58.3	44.5

Table 1. Patient and Hospital Characteristics of Hospitalizations With NVUGIB by Hospital Setting

Variable

Non-teaching hospital, %

Teaching hospital, %

P-value

^aFor 2017. NVUGIB: non-variceal upper gastrointestinal bleeding; SE: standard error of the mean; HIV: human immunodeficiency virus; AIDS: acquired immunodeficiency syndrome.

N = 94,900

n = 34,725 (36.6%)

n = 60,175 (63.4%)

Patient characteristics

Age, years, mean ± SE

64.8 ± 0.5

62.8 ± 0.4

< 0.001

18 - 44 years

14.4

16.5

45 - 64 years

30.5

34.1

> 64 years

55.1

49.4

Women

40.3

37.7

< 0.001

Racial distribution

< 0.001

White

72.9

64.4

Black

9.3

14.7

Hispanic

9.0

11.1

Others

8.8

9.8

Charlson Comorbidity Index score

<0.001

19.1

19.2

25.5

23.2

17.4

16.2

≥ 3

38.0

41.4

Primary payer

< 0.001

Medicare

62.1

55.9

Medicaid

14.2

16.6

Private

18.1

21.5

Uninsured

5.6

6.0

Median annual income in patient’s zip code, US$^a

< 0.001

1 - 43,999

32.3

30.0

44,000 - 55,999

29.3

24.8

56,000 - 73,999

22.2

24.5

≥ 74,000

16.2

20.7

Comorbidities

Myocardial infarction

8.7

9.1

0.390

Congestive heart failure

15.1

16.7

0.004

Peripheral vascular disease

8.5

8.8

0.488

Cerebrovascular disease

4.7

5.1

0.205

Dementia

9.3

7.5

< 0.001

Chronic pulmonary disease

21.3

19.6

0.007

Rheumatologic disease

3.1

2.8

0.384

Peptic ulcer disease

28.6

26.7

0.009

Mild liver disease

8.2

9.7

< 0.001

Diabetes without complications

16.5

15.1

0.014

Diabetes with complications

10.4

12.1

0.001

Hemiplegia/paraplegia

0.8

1.1

0.118

Renal disease

20.3

22.4

0.001

Any malignancy

3.6

3.9

0.482

Moderate or severe liver disease

7.4

9.5

< 0.001

Metastatic solid tumor

2.0

2.5

0.036

HIV/AIDS

0.2

0.5

0.009

Hospital characteristics

Hospital region

< 0.001

Northeast

11.7

20.3

Midwest

19.7

21.6

South

42.4

36.3

West

26.2

21.8

Hospital bed size

< 0.001

Small

12.8

23.0

Medium

28.9

32.5

Large

58.3

44.5

**Table 2.** Outcomes of NVUGIB Patients Managed at Non-Teaching vs. Teaching Hospitals
Outcome	Non-teaching hospital, %	Teaching hospital, %	aOR (95% CI)	P-value
*Statistically significant. ^aAdjusted mean difference. aOR: adjusted odds ratio; CI: confidence interval; NVUGIB: non-variceal upper gastrointestinal bleeding.
No. (%)	n = 34,725 (36.6%)	n = 60,175 (63.4%)
Primary outcome
In-hospital mortality	1.50	1.98	1.38 (1.08 - 1.77)	0.010*
Secondary outcomes
Endoscopy	24.5	27.0	1.10 (1.02 - 1.19)	0.016*
Time to endoscopy, mean, days	1.0	1.1	0.0 (-0.1 - 0.1)	0.763
Early endoscopy	19.3	20.7	1.06 (0.98 - 1.16)	0.162
Intubation	3.3	5.4	1.62 (1.36 - 1.94)	< 0.001*
Mechanical ventilation	3.9	6.4	1.62 (1.38 - 1.90)	< 0.001*
Transfusion of blood products	34.7	32.2	0.94 (0.88 - 1.01)	0.112
Acute renal failure	18.8	21.9	1.17 (1.07 - 1.28)	< 0.001*
Acute respiratory failure	4.4	5.8	1.28 (1.10 - 1.50)	0.002*
Sepsis	1.8	2.3	1.16 (0.92 - 1.47)	0.213
Length of stay, mean, days	4.1	4.6	0.5^a (0.4 - 0.6)	< 0.001*
Total hospital charges, mean, US$	45168	51605	2,253^a (230 - 4,275)	0.029*

Table 2. Outcomes of NVUGIB Patients Managed at Non-Teaching vs. Teaching Hospitals

Outcome

Non-teaching hospital, %

Teaching hospital, %

aOR (95% CI)

P-value

*Statistically significant. ^aAdjusted mean difference. aOR: adjusted odds ratio; CI: confidence interval; NVUGIB: non-variceal upper gastrointestinal bleeding.

No. (%)

n = 34,725 (36.6%)

n = 60,175 (63.4%)

Primary outcome

In-hospital mortality

1.50

1.98

1.38 (1.08 - 1.77)

0.010*

Secondary outcomes

Endoscopy

24.5

27.0

1.10 (1.02 - 1.19)

0.016*

Time to endoscopy, mean, days

1.0

1.1

0.0 (-0.1 - 0.1)

0.763

Early endoscopy

19.3

20.7

1.06 (0.98 - 1.16)

0.162

Intubation

3.3

5.4

1.62 (1.36 - 1.94)

< 0.001*

Mechanical ventilation

3.9

6.4

1.62 (1.38 - 1.90)

< 0.001*

Transfusion of blood products

34.7

32.2

0.94 (0.88 - 1.01)

0.112

Acute renal failure

18.8

21.9

1.17 (1.07 - 1.28)

< 0.001*

Acute respiratory failure

4.4

5.8

1.28 (1.10 - 1.50)

0.002*

Sepsis

1.8

2.3

1.16 (0.92 - 1.47)

0.213

Length of stay, mean, days

4.1

4.6

0.5^a (0.4 - 0.6)

< 0.001*

Total hospital charges, mean, US$

45168

51605

2,253^a (230 - 4,275)

0.029*