Yasir Al-Aboodi, MD, MPH1, Ahmed Al-Chalabi, MD, MSc2, Abdallah Kobeissy, MD1, Thomas Sodeman, MD1, Ali Nawras, MD, FACG1
1University of Toledo Medical Center, Toledo, OH; 2University of Toledo, Toledo, OH
Introduction: We occasionally encounter patients with upper gastrointestinal bleed (UGIB) who also happen to have coronary syndrome (ACS) during the same admission. In this study we tried to give a better insight about this target population demography and what’s the best approach in terms of treatment options and its relationship with the inpatient mortality.
Methods: We did retrospective analysis using the National Inpatient Data base (NIS) for 2014. Its the largest available public all payer and it includes more than 7millions inpatients admission. we examine the mortality difference among people who were admitted for UGIB and ACS and received different interventions approach including no interventions, endoscopy (Colonscopy/Endoscopy), Left heart Cath, or combination of left heart Cath and endoscopy.All diagnosis and procedures were captured using the the international code for disease version nine ( ICD9).
Results: 2830 ACS and UGIB related admission were extracted from the data. Mean age is 68 yr. 62% (1750) male and 38% (1075) female. 73% (2070) white;14% (400) black; 7.1% (200) Hispanic ;65(2.3%) Asian;25(0.9%) Native; %Others 2.5%. 195 out of the 2830 died. Of the 195 dead, 130(66.7%) received no interventions,50(25.6%) received scopes only,10(5.1%) received left hearth catheterization only and 5 (2.6%) received both scopes and left hearth catheter. Considering no intervention as a reference, the likelihood of surviving are 3.3, 3.1, and 1.5 among combined therapy, Left heart Cath only and scopes only respectively(P< 0.005,CI 95% 1.3-2.5).
Discussion: Combined approach of endoscopy(colonoscopy/EGD) and left hearth catheterization for people with (UGIB and ACS) related admission have 3 times more likelihood to survive compared to patients who received no intervention
Citation: Yasir Al-Aboodi, MD, MPH; Ahmed Al-Chalabi, MD, MSc; Abdallah Kobeissy, MD; Thomas Sodeman, MD; Ali Nawras, MD, FACG. P1311 - AGGRESSIVE APPROACH SAVE LIFE IN PEOPLE ADMITTED FOR BOTH UPPER GI BLEEDING AND ACUTE CORONARY SYNDROME. Program No. P1311. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.