The changing face of hospitalization due to gastrointestinal bleeding and perforation

Angel Lanas (1, 2, 3) , Luis Alberto Garcia Rodriguez (4) , Monica Polo-Tomas (5) , Marta Ponce (6) , Enrique Quintero (7) , Maria Angeles Perez-Aisa (8) , Javier P Gisbert (9) , Luis Bujanda (10) , Manuel Castro (11) , Maria Muñoz (1) , Maria Dolores del Pino (1) , Santiago Garcia (12) , Xavier Calvet (13)

1 Gastroenterology
2 Medicine
3 CIBERehd - Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas
4 Centro Español de Investigacion Farmacoepidemiologica (CEIFE)
5 Division of Gastroenterology
6 Gastroenterology Unit
7 Gastroenterology
8 Gastroeneterology
9 Division of Gastroenterology
10 Gastroenterology
11 Gastroenterology Department
12 Gastroenterology
13 Gastroenterology

Background: Temporal changes in the incidence of cause-specific gastrointestinal (GI) complications may be one of the factors underlying changing medical practice patterns. Aim: To report temporal changes in the incidence of five major causes of specific gastrointestinal (GI) complication events. Methodology: Population-based study of patients hospitalized due to GI bleeding and perforation from 1996-2005 in Spain. We report crude rates, and estimate regression coefficients of temporal trends, severity, and recorded drug use for 5 frequent GI events. GI hospitalization charts were validated by independent review of large random samples. Results: The incidence per 100,000 person-years of hospitalizations due to upper GI ulcer bleeding and perforation decreased over time (from 54.6 and 3.9 in 1996 [R2=0.944] to 25.8 and 2.9 in 2005 [R2=0.410], respectively). On the contrary, the incidence per 100,000 person-years of colonic diverticular and angiodysplasia bleeding increased over time (3.3 and 0.9 in 1996 [R2=0.443] and 8.0 and 2.6 in 2005 [R2=0.715], respectively). A small increasing trend was observed for the incidence per 100,000 person-years of intestinal perforations (from 1.5 to 2.3 events). Based on data extracted from the validation process, recent recorded drug intake showed an increased frequency of anticoagulants with colonic diverticular and angiodysplasia bleeding, whereas NSAID and low-dose aspirin use were more prevalent in peptic ulcer bleeding and colonic diverticular bleeding respectively. Conclusions: From 1996-2005, hospitalizations due to peptic ulcer bleeding and perforation have decreased significantly, whereas the number of cases of colonic diverticular and angiodysplasia bleeding have increased.

Mots clés: Medicine

Angel Lanas, Luis Alberto Garcia Rodriguez, Monica Polo-Tomas, Marta Ponce, Enrique Quintero, et al.. The changing face of hospitalization due to gastrointestinal bleeding and perforation. Alimentary Pharmacology and Therapeutics, 2011, 33 (5), pp.585. ⟨10.1111/j.1365-2036.2010.04563.x⟩. ⟨hal-00605960⟩