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Scand J Gastroenterol ; 59(5): 615-622, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38305194

RESUMO

BACKGROUND: This retrospective study, conducted using the U.S. National Inpatient Sample (NIS), examines the outcomes and management of nonvariceal upper gastrointestinal bleeding (NVUGIB) in COVID-19 patients and identifies predictive factors to enhance patient prognosis. METHODS: We analyzed the 2020 U.S. NIS data involving adult patients (≥18 years) admitted with NVUGIB and categorized them based on the presence of COVID-19. Primary and secondary outcomes, NVUGIB-related procedures, and predictive factors were evaluated. RESULTS: Of 184,885 adult patients admitted with NVUGIB, 1.6% (2990) had COVID-19. Patients with NVUGIB and COVID-19 showed higher inpatient mortality, acute kidney injury, need for intensive care, and resource utilization metrics. Notably, there was a lower rate of early esophagogastroduodenoscopy (EGD). Multivariate logistic regression revealed conditions like peptic ulcer disease, mechanical ventilation, and alcohol abuse as significant positive predictors for NVUGIB in COVID-19 patients, whereas female gender and smoking were negative predictors. CONCLUSION: Our findings suggest that COVID-19 significantly increases the risk of mortality and complications in NVUGIB patients. The observed decrease in early EGD interventions, potentially contributing to higher mortality rates, calls for a review of treatment strategies. Further multicenter, prospective studies are needed to validate these results and improve patient care strategies.


Assuntos
COVID-19 , Hemorragia Gastrointestinal , Mortalidade Hospitalar , Humanos , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/mortalidade , Masculino , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/terapia , Estudos Retrospectivos , Pessoa de Meia-Idade , Idoso , Estados Unidos/epidemiologia , Adulto , SARS-CoV-2 , Fatores de Risco , Pacientes Internados/estatística & dados numéricos , Idoso de 80 Anos ou mais , Prognóstico , Endoscopia do Sistema Digestório , Hospitalização/estatística & dados numéricos
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