Hospitalised incidence and case fatality for upper gastrointestinal bleeding from 1999 to 2007: A record linkage study

Lori Button (1) , Stephen Roberts (2) , Adrian Evans (1) , Michael J Goldacre (3) , Ashley Akbari (1) , Steven Macey (1) , John G Williams (2, 4) , Rohan Dsilva (1)

1 School of Medicine
2 School of Medicine
3 Unit of Health-Care Epidemiology
4 Gastroenterology

Background: Upper gastrointestinal (GI) bleeding is the most common emergency managed by gastroenterologists. Aim: To establish the hospitalised incidence and case fatality for upper gastrointestinal bleeding, and to determine how they are associated with factors including day of admission, hospital size, social deprivation and distance from hospital. Methods: Systematic record linkage of hospital inpatient and mortality data for 24 421 admissions for upper GI bleeding among 22 299 people in Wales from 1999-2007. Results: Hospitalised incidence of upper GI bleeding was 134 per 100 000. Case fatality was 10.0%. Incidence was stable from 1999 to 2007; case fatality fell by 3.1% per year (95% CI = 1.3%-4.8%). Incidence was associated significantly with social deprivation. Compared with weekday admissions, case fatality was 13% higher for weekend admissions and 41% higher for admissions on public holidays. There was little variation in case fatality according to social deprivation, hospital size or distance from hospital. Conclusions: Incidence, but not case fatality, was associated significantly with social deprivation. The higher mortality for weekend and public holiday admissions could not be explained by measures of case mix and may indicate a possible impact of reduced staffing levels and delays to endoscopy at weekends in some hospitals.

Mots clés: Medicine

Lori Button, Stephen Roberts, Adrian Evans, Michael J Goldacre, Ashley Akbari, et al.. Hospitalised incidence and case fatality for upper gastrointestinal bleeding from 1999 to 2007: A record linkage study. Alimentary Pharmacology and Therapeutics, 2010, 33 (1), pp.64. ⟨10.1111/j.1365-2036.2010.04495.x⟩. ⟨hal-00599483⟩