title: Increased mortality with peptic ulcer bleeding in patients with both compensated and decompensated cirrhosis.
abstract: BACKGROUND
  Cirrhosis is associated with worse outcomes in peptic ulcer bleeding (PUB). There are no population-based studies from the United States on the impact of cirrhosis on PUB outcomes.
  
  
  OBJECTIVE
  To investigate the impact of cirrhosis on outcomes of patients with PUB.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Nationwide Inpatient Sample 2009.
  
  
  METHODS
  International Classification of Diseases, the 9th revision, codes were used to identify patients with PUB and cirrhosis. The control group was patients with PUB without cirrhosis.
  
  
  METHODS
  In-hospital mortality, length of stay, and hospitalization costs.
  
  
  RESULTS
  A total of 96,887 discharges with PUB as a diagnosis were identified-3574 with PUB and cirrhosis and 93,313 with PUB alone without cirrhosis. Mortality of PUB with concomitant cirrhosis was higher than in the control group without cirrhosis (5.5% vs 2%; P = .01); decompensated cirrhosis had higher mortality than did compensated cirrhosis (6.6% vs 3.9%; P = .01). In multivariate analysis, the presence of cirrhosis independently increased mortality (adjusted odds ratio (aOR) 3.3; 95% confidence interval [CI], 2.2-4.9). Stratified analysis showed that decompensated cirrhosis (aOR 4.4; 95% CI, 2.6-7.3) had higher mortality than compensated cirrhosis (aOR 1.9; 95% CI, 1.04-3.6). There was no difference in the proportion of patients who underwent endoscopy within 24 hours (51.9% vs 51.1%; P = .68) between those with cirrhosis and controls. Patients with cirrhosis received less surgical intervention (aOR 0.8; 95% CI, 0.6-0.9) compared with controls. Hospitalization costs also were increased in patients with decompensated cirrhosis.
  
  
  CONCLUSIONS
  Administrative data set.
  
  
  CONCLUSIONS
  Both decompensated and compensated cirrhosis are associated with increased mortality in patients with PUB.
authors.affiliation: Digestive Disease Institute, The Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Preethi G K
authors.initials: PG
authors.lastname: Venkatesh
authors.affiliation: Department of Medicine, Kansas University Medical Center, Kansas City, Kansas, USA.
authors.forename: Sravanthi
authors.initials: S
authors.lastname: Parasa
authors.affiliation: Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
authors.forename: Basile
authors.initials: B
authors.lastname: Njei
authors.affiliation: Digestive Disease Institute, The Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Madhusudhan R
authors.initials: MR
authors.lastname: Sanaka
authors.affiliation: Digestive Disease Institute, The Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Udayakumar
authors.initials: U
authors.lastname: Navaneethan
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications* / Q000191:economics / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000150:complications* / Q000191:economics / Q000401:mortality* / Q000601:surgery; D012189:Retrospective Studies