Poster D0302 – Hospital Outcomes in Patients With Gastrointestinal Bleeding on Primary Prevention Aspirin: A Nationwide Emergency Department Sample Analysis
Tuesday, October 25, 2022 | 10:00 AM – 12:00 PM ET | Location: Crown Ballroom
Author Insight from Darrick K. Li, MD, PhD, Yale University School of Medicine
What’s new here and important for clinicians?
While it is known that low-dose aspirin is commonly used for primary cardiovascular prevention, little is known regarding the national burden of ED visits and hospitalizations due to GI bleeding related to the use of primary prevention aspirin and in-hospital outcomes in primary prevention aspirin users versus non-users presenting with GI bleeding. In our study based on the Nationwide Emergency Department Sample Analysis from 2016-2019, we show:
- Between 2016-2019, there were an estimated 725,000 emergency room visits nationwide for upper GI bleeding in patients who were on primary prevention aspirin.
- Peptic ulcer disease was the most common cause of GIB.
- Overall, patients who were on primary prevention aspirin presenting with upper GI bleeding were less likely to be discharged from the ED and more likely to require red blood cell transfusion and endoscopic hemostatic intervention compared to non-ASA users.
- In-hospital mortality was significantly less likely in aspirin users than in non-aspirin users.
- Stratified by age, risk of inpatient admission, red blood cell transfusion, and endoscopic intervention all became significant at age ≥60.
While the absolute risk of bleeding while on primary prevention aspirin is low, given the estimated 29 million individuals on primary prevention aspirin, the overall national burden of emergency room visits and inpatient hospitalization is substantial. Our study is the first study to assess the nationwide burden of emergency room visits and hospital admissions for gastrointestinal bleeding for patients on primary prevention aspirin.
What do patients need to know?
- Aspirin for primary prevention is indicated for an increasingly selective population of individuals based on recent guideline changes.
- While the absolute risk of bleeding while on primary prevention aspirin is low, the overall national burden of emergency room visits and inpatient hospitalization is substantial.
- Patients presenting with upper GI bleeding who are on aspirin for primary prevention are more likely to be admitted to the hospital, receive a blood transfusion, and require endoscopic therapy to control the bleeding.
Read the Abstract
Darrick K. Li, MD, PhD, Yale University School of Medicine
darrick.li [at] yale.edu
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