Gastrointestinal bleeding in hospitalized children in the United States.
OBJECTIVE
To investigate the epidemiology of GI bleeding in hospitalized children in the United States.


METHODS
Data were obtained from the Healthcare Cost and Utilization Project Kids' Inpatient Database, Agency for Healthcare Research and Quality for the year 2009. The data were weighted to generate national-level estimates.


RESULTS
There were 23,383 pediatric discharges with a diagnosis of GI bleeding accounting for 0.5% of all discharges. Children with a GI bleed compared to those without were more likely to be male (54.5% vs. 45.8%; P < 0.001), older (children ≥11 years; 50.8% vs. 38.7%; P < 0.001), and admitted to a teaching hospital (70.5% vs. 56.4%; P < 0.001). Children 11-15 years of age had the highest incidence of GI bleeding (84.2 per 10,000 discharges) and children less than 1 year of age the lowest (24.4 per 10,000 discharges). The highest incidence of GI bleeding was attributable to cases coded as blood in stool (17.6 per 10,000 discharges) followed by hematemesis (11.2 per 10,000 discharges). Those with a GI bleed had a higher co-morbid burden (12.3% vs. 2.3%; P < 0.001) and severity of illness (40.1% vs. 14.5%; P < 0.001). The highest mortality rates associated with GI bleeding were observed in cases with intestinal perforation (8.7%) and esophageal perforation (8.4%). GI bleeding was independently associated with a higher risk of mortality (aOR 1.68, CI 1.53-1.84).


CONCLUSIONS
Our results describe the epidemiology of GI bleeding in hospitalized children within the United States. We found a substantial risk of mortality attributable to GI bleeding in this patient population. Our study is limited by the exclusion of non-hospitalized children, the reliance on ICD-9-CM codes and the absence of longitudinal follow up of patients.
Department of Medicine, Kansas University Medical Center , Kansas City, KS , USA.
Chaitanya
C
Pant
Senthilkumar
S
Sankararaman
Abhishek
A
Deshpande
Mojtaba
M
Olyaee
Michael P
MP
Anderson
Thomas J
TJ
Sferra
D000293:Adolescent; D002648:Child; D016208:Databases, Factual; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
Adolescent; Child; Epidemiology; Gastrointestinal bleeding; Incidence; Outcomes; Pediatric