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OC-056 Long-Term Trends in Comorbidity and Risk Scores and their Influence on outcomes of upper Gastrointestinal Bleeding
  1. A S Taha1,
  2. E Saffouri1,
  3. C McCloskey2,
  4. T Craigen2,
  5. W J Angerson3
  1. 1Medicine, University of Glasgow, Glasgow
  2. 2Medicine, University Hospital Crosshouse, Kilmarnock
  3. 3Surgery, University of Glasgow, Glasgow, UK

Abstract

Introduction The prevention of upper gastrointestinal bleeding (UGIB) can be facilitated by understanding the changes in environmental and socio-pathological factors; these might not become obvious in short-term studies. We, therefore, aimed to study the changes in comorbidity and risk scores and their influence on the outcomes of UGIB over a 14-year period.

Methods We analysed the clinical characteristics of all patients presenting with UGIB to a single institution, 1996–2010. The Charlson’s comorbidity and the complete Rockall scores were analysed, together with patients’ drug use and 30-day mortality. Trends with time were assessed using logistic regression analysis with year of presentation as a continuous predictor variable. Regression coefficients were expressed as odds ratios (OR), representing the relative change in odds of death or other binary dependent variables over a time interval of one year.

Results A total of 2669 patients were included. The Charlson score increased significantly with time (P < 0.001), the odds of a high (3+) score increasing at a relative rate of 4.4% a year (OR = 1.044, 95% CI 1.022–1.065). No significant trend with time was noted for age (p = 0.09), haemoglobin level (P = 0.47) or Rockall score (P = 0.94). The overall 30-day mortality was 4.9% and this showed no relationship with time (P = 0.28). However, when adjusted for the increasing comorbidity, the odds of death within 30 days decreased significantly at a relative rate of 4.5% per year [OR = 0.955 (0.914–0.997); P = 0.038]. Trends in the prevalence of taking potentially damaging and protective drugs are shown in Table-1, below. The rise in use of aspirin, other anti-thrombotic drugs and SSRIs [with pro-UGIB activity] was paralleled by a rise in the use of PPIs [protective activity] and beta-blockers, ACE inhibitors, and statins [being able to affect mortality.

Abstract OC-056 Table 1

Trends in the prevalence of taking potentially damaging and protective drugs

Conclusion Patients with UGIB presented with progressively increasing comorbidity over the 14-year period 1996–2010. The use of both potentially damaging and protective drugs also increased. Raw 30-day mortality was unchanged over the same period, but decreased significantly with time when adjusted for comorbidity. These observations might have clinical implications.

Disclosure of Interest A. Taha Consultant for: Horizon Pharma USA; Vifor Pharma UK, E. Saffouri: None Declared, C. McCloskey: None Declared, T. Craigen: None Declared, W. Angerson: None Declared

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