End-stage renal disease is associated with worse outcomes in hospitalized patients with peptic ulcer bleeding.
BACKGROUND
Patients with end-stage renal disease (ESRD) are at increased risk of peptic ulcer bleeding (PUB). To our knowledge, there are no population-based studies of the impact of ESRD on PUB.


OBJECTIVE
To determine nationwide impact of ESRD on outcomes of hospitalized patients with PUB.


METHODS
Cross-sectional study.


METHODS
Hospitals from a 2008 Nationwide Inpatient Sample.


METHODS
We used the International Classification of Diseases, the 9th Revision, Clinical Modification codes to identify patients who had a primary discharge diagnosis of PUB.


METHODS
In-hospital mortality, length of stay, and hospitalization charges.


METHODS
Comparison of PUB outcomes in patients with and without ESRD.


RESULTS
Of a total of 102,525 discharged patients with PUB, 3272 had a diagnosis of both PUB and ESRD, whereas 99,253 had a diagnosis of PUB alone without ESRD. The mortality of ESRD patients with PUB was significantly higher than that of the control group without ESRD (4.8% vs 1.9%, P < .0001). On multivariate analysis, patients with PUB and ESRD had greater mortality than patients admitted to the hospital with PUB alone (adjusted odds ratio [aOR] 2.1; 95% confidence interval [CI], 1.3-3.4), were more likely to undergo surgery (aOR 1.4; 95% CI, 1.2-1.7), and had a longer hospital stay (aOR 2.1; 95% CI, 1.2-2.9). These patients also incurred higher hospitalization charges ($54,668 vs $32,869, P < .01) compared with patients with PUB alone.


CONCLUSIONS
Administrative data set.


CONCLUSIONS
ESRD is associated with a significant health care burden in hospitalized patients with PUB. The presence of ESRD contributes to a higher mortality rate, longer hospital stay, and increased need for surgery.
Department of Medicine, Washington Hospital Center, Washington, DC, USA.
Sravanthi
S
Parasa
Udayakumar
U
Navaneethan
Arun Raghav Mahankali
AR
Sridhar
Preethi G K
PG
Venkatesh
Kevin
K
Olden
D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010438:Peptic Ulcer Hemorrhage / Q000150:complications* / Q000191:economics / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult