title: Hospitalization for variceal hemorrhage in an era with more prevalent cirrhosis.
abstract: OBJECTIVE
  To examine hospitalization rates for variceal hemorrhage and relation to cause of cirrhosis during an era of increased cirrhosis prevalence.
  
  
  METHODS
  We performed a retrospective review of patients with cirrhosis and gastroesophageal variceal hemorrhage who were admitted to a tertiary care referral center from 1998 to 2009. Subjects were classified according to the etiology of their liver disease: alcoholic cirrhosis and non-alcoholic cirrhosis. Rates of hospitalization for variceal bleeding were determined. Data were also collected on total hospital admissions per year and cirrhosis-related admissions per year over the same time period. These data were then compared and analyzed for trends in admission rates.
  
  
  RESULTS
  Hospitalizations for cirrhosis significantly increased from 611 per 100000 admissions in 1998-2001 to 1232 per 100000 admissions in 2006-9 (P value for trend < 0.0001). This increase was seen in admissions for both alcoholic and non-alcoholic cirrhosis (P values for trend < 0.001 and < 0.0001 respectively). During the same time period, there were 243 admissions for gastroesophageal variceal bleeding (68% male, mean age 54.3 years, 62% alcoholic cirrhosis). Hospitalizations for gastroesophageal variceal bleeding significantly decreased from 96.6 per 100000 admissions for the time period 1998-2001 to 70.6 per 100000 admissions for the time period 2006-2009 (P value for trend = 0.01). There were significant reductions in variceal hemorrhage from non-alcoholic cirrhosis (41.6 per 100000 admissions in 1998-2001 to 19.7 per 100000 admissions in 2006-2009, P value for trend = 0.007).
  
  
  CONCLUSIONS
  Hospitalizations for variceal hemorrhage have decreased, most notably in patients with non-alcoholic cirrhosis, and this may reflect broader use of strategies to prevent bleeding.
authors.affiliation: Nicholas Lim, Steven D Lidofsky, Eric Ganguly, Division of Gastroenterology and Hepatology, University of Vermont College of Medicine, Burlington, VT 05401, United States.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lim
authors.affiliation: Nicholas Lim, Steven D Lidofsky, Eric Ganguly, Division of Gastroenterology and Hepatology, University of Vermont College of Medicine, Burlington, VT 05401, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Desarno
authors.affiliation: Nicholas Lim, Steven D Lidofsky, Eric Ganguly, Division of Gastroenterology and Hepatology, University of Vermont College of Medicine, Burlington, VT 05401, United States.
authors.forename: Steven D
authors.initials: SD
authors.lastname: Lidofsky
authors.affiliation: Nicholas Lim, Steven D Lidofsky, Eric Ganguly, Division of Gastroenterology and Hepatology, University of Vermont College of Medicine, Burlington, VT 05401, United States.
authors.forename: Eric
authors.initials: E
authors.lastname: Ganguly
mesh_terms: D003430:Cross-Sectional Studies; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D014707:Vermont / Q000453:epidemiology
keywords: Cirrhosis; Gastrointestinal bleeding; Hospitalization; Portal hypertension; Varices