Upper versus lower gastrointestinal bleeding: a direct comparison of clinical presentation, outcomes, and resource utilization.
OBJECTIVE
To compare prevalence, clinical outcomes, and resource utilization between subjects with lower gastrointestinal bleeding (LGIB) and upper gastrointestinal bleeding (UGIB).


METHODS
Using administrative data, patient surveys, and chart abstraction, comparisons between subjects admitted with LGIB and UGIB were made by employing bivariate and multivariate statistics.


RESULTS
A total of 367 subjects were identified, LGIB = 187 and UGIB = 180. Subjects with UGIB compared to LGIB had greater admission hemodynamic instability including tachycardia and orthostasis but clinical outcomes were similar. In multivariate analyses, no significant differences were observed for in-hospital mortality transfer to the intensive care unit (ICU) or 30-day readmission rate. Resource utilization was similar in UGIB and LGIB, including mean costs, length of stay, and number of endoscopic procedures.


CONCLUSIONS
Unlike prior studies, this direct comparison of LGIB to UGIB identified more similarities than differences with similar prevalence rates, clinical outcomes, and resource utilization, suggesting that the epidemiology of gastrointestinal bleeding may be changing.
Department of Internal Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois 60153, USA. cwhelan@lumc.edu
Chad T
CT
Whelan
Connie
C
Chen
Peter
P
Kaboli
Juned
J
Siddique
Micah
M
Prochaska
David O
DO
Meltzer
D000368:Aged; D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D006801:Humans; D041741:Lower Gastrointestinal Tract / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000473:pathology / Q000503:physiopathology