Declining Hospitalization Rate of Esophageal Variceal Bleeding in the United States

M. Mazen Jamal, Jason B. Samarasena, Mehrtash Hashemzadeh, Kenneth J Vega

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background & Aims: In recent years, there have been many advances in the primary and secondary prophylaxis of variceal bleeding. The aim of this study was to evaluate nationwide trends in the hospitalization rate of bleeding esophageal varices in the advent of these new modalities. In addition, our aims were to study the incidence trends of nonbleeding esophageal varices over the past 2 decades while studying hospitalization rates for cirrhosis over the same study period. Methods: The Nationwide Inpatient Sample database was used for inpatient data analysis (1988-2002) and the State Ambulatory Surgery Database was used for outpatient analysis. Patients discharged with International Classification of Diseases, ninth revision, Clinical Modification discharge diagnoses related to esophageal varices were included. Results: The hospitalization rate of bleeding varices increased 13.7% from 10.9 per 100,000 in the 1988 to 1990 period to 12.4 per 100,000 in the 1994 to 1996 period (P < .01), and then decreased 14.5% to 10.6 per 100,000 in the 2000 to 2002 period (P < .01). In-hospital nonbleeding varices increased 55% from 6.0 to 9.3 per 100,000 from the 1988 to 1990 period to the 2000 to 2002 period (P < .01). Outpatient nonbleeding esophageal varices increased 20% from 5.5 to 6.6 per 100,000 from 1997 to 2003. Conclusions: The hospitalization rate for bleeding esophageal varices has been on the decline in recent years and may be a reflection of the advances in primary and secondary prophylaxis. The incidence rate of nonbleeding esophageal varices is increasing and likely is owing to the increasing burden of portal hypertensive liver disease in the nation.

Original languageEnglish (US)
Pages (from-to)689-695
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume6
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Fingerprint

Esophageal and Gastric Varices
Hospitalization
Hemorrhage
Varicose Veins
Inpatients
Outpatients
Databases
International Classification of Diseases
Ambulatory Surgical Procedures
Liver Diseases
Fibrosis
Cohort Studies
Incidence

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Declining Hospitalization Rate of Esophageal Variceal Bleeding in the United States. / Jamal, M. Mazen; Samarasena, Jason B.; Hashemzadeh, Mehrtash; Vega, Kenneth J.

In: Clinical Gastroenterology and Hepatology, Vol. 6, No. 6, 01.06.2008, p. 689-695.

Research output: Contribution to journalArticle

Jamal, M. Mazen ; Samarasena, Jason B. ; Hashemzadeh, Mehrtash ; Vega, Kenneth J. / Declining Hospitalization Rate of Esophageal Variceal Bleeding in the United States. In: Clinical Gastroenterology and Hepatology. 2008 ; Vol. 6, No. 6. pp. 689-695.
@article{b1d15a8e4f1f4222845a821cf512b910,
title = "Declining Hospitalization Rate of Esophageal Variceal Bleeding in the United States",
abstract = "Background & Aims: In recent years, there have been many advances in the primary and secondary prophylaxis of variceal bleeding. The aim of this study was to evaluate nationwide trends in the hospitalization rate of bleeding esophageal varices in the advent of these new modalities. In addition, our aims were to study the incidence trends of nonbleeding esophageal varices over the past 2 decades while studying hospitalization rates for cirrhosis over the same study period. Methods: The Nationwide Inpatient Sample database was used for inpatient data analysis (1988-2002) and the State Ambulatory Surgery Database was used for outpatient analysis. Patients discharged with International Classification of Diseases, ninth revision, Clinical Modification discharge diagnoses related to esophageal varices were included. Results: The hospitalization rate of bleeding varices increased 13.7{\%} from 10.9 per 100,000 in the 1988 to 1990 period to 12.4 per 100,000 in the 1994 to 1996 period (P < .01), and then decreased 14.5{\%} to 10.6 per 100,000 in the 2000 to 2002 period (P < .01). In-hospital nonbleeding varices increased 55{\%} from 6.0 to 9.3 per 100,000 from the 1988 to 1990 period to the 2000 to 2002 period (P < .01). Outpatient nonbleeding esophageal varices increased 20{\%} from 5.5 to 6.6 per 100,000 from 1997 to 2003. Conclusions: The hospitalization rate for bleeding esophageal varices has been on the decline in recent years and may be a reflection of the advances in primary and secondary prophylaxis. The incidence rate of nonbleeding esophageal varices is increasing and likely is owing to the increasing burden of portal hypertensive liver disease in the nation.",
author = "Jamal, {M. Mazen} and Samarasena, {Jason B.} and Mehrtash Hashemzadeh and Vega, {Kenneth J}",
year = "2008",
month = "6",
day = "1",
doi = "10.1016/j.cgh.2008.02.049",
language = "English (US)",
volume = "6",
pages = "689--695",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Declining Hospitalization Rate of Esophageal Variceal Bleeding in the United States

AU - Jamal, M. Mazen

AU - Samarasena, Jason B.

AU - Hashemzadeh, Mehrtash

AU - Vega, Kenneth J

PY - 2008/6/1

Y1 - 2008/6/1

N2 - Background & Aims: In recent years, there have been many advances in the primary and secondary prophylaxis of variceal bleeding. The aim of this study was to evaluate nationwide trends in the hospitalization rate of bleeding esophageal varices in the advent of these new modalities. In addition, our aims were to study the incidence trends of nonbleeding esophageal varices over the past 2 decades while studying hospitalization rates for cirrhosis over the same study period. Methods: The Nationwide Inpatient Sample database was used for inpatient data analysis (1988-2002) and the State Ambulatory Surgery Database was used for outpatient analysis. Patients discharged with International Classification of Diseases, ninth revision, Clinical Modification discharge diagnoses related to esophageal varices were included. Results: The hospitalization rate of bleeding varices increased 13.7% from 10.9 per 100,000 in the 1988 to 1990 period to 12.4 per 100,000 in the 1994 to 1996 period (P < .01), and then decreased 14.5% to 10.6 per 100,000 in the 2000 to 2002 period (P < .01). In-hospital nonbleeding varices increased 55% from 6.0 to 9.3 per 100,000 from the 1988 to 1990 period to the 2000 to 2002 period (P < .01). Outpatient nonbleeding esophageal varices increased 20% from 5.5 to 6.6 per 100,000 from 1997 to 2003. Conclusions: The hospitalization rate for bleeding esophageal varices has been on the decline in recent years and may be a reflection of the advances in primary and secondary prophylaxis. The incidence rate of nonbleeding esophageal varices is increasing and likely is owing to the increasing burden of portal hypertensive liver disease in the nation.

AB - Background & Aims: In recent years, there have been many advances in the primary and secondary prophylaxis of variceal bleeding. The aim of this study was to evaluate nationwide trends in the hospitalization rate of bleeding esophageal varices in the advent of these new modalities. In addition, our aims were to study the incidence trends of nonbleeding esophageal varices over the past 2 decades while studying hospitalization rates for cirrhosis over the same study period. Methods: The Nationwide Inpatient Sample database was used for inpatient data analysis (1988-2002) and the State Ambulatory Surgery Database was used for outpatient analysis. Patients discharged with International Classification of Diseases, ninth revision, Clinical Modification discharge diagnoses related to esophageal varices were included. Results: The hospitalization rate of bleeding varices increased 13.7% from 10.9 per 100,000 in the 1988 to 1990 period to 12.4 per 100,000 in the 1994 to 1996 period (P < .01), and then decreased 14.5% to 10.6 per 100,000 in the 2000 to 2002 period (P < .01). In-hospital nonbleeding varices increased 55% from 6.0 to 9.3 per 100,000 from the 1988 to 1990 period to the 2000 to 2002 period (P < .01). Outpatient nonbleeding esophageal varices increased 20% from 5.5 to 6.6 per 100,000 from 1997 to 2003. Conclusions: The hospitalization rate for bleeding esophageal varices has been on the decline in recent years and may be a reflection of the advances in primary and secondary prophylaxis. The incidence rate of nonbleeding esophageal varices is increasing and likely is owing to the increasing burden of portal hypertensive liver disease in the nation.

UR - http://www.scopus.com/inward/record.url?scp=44749087827&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=44749087827&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2008.02.049

DO - 10.1016/j.cgh.2008.02.049

M3 - Article

C2 - 18456566

AN - SCOPUS:44749087827

VL - 6

SP - 689

EP - 695

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 6

ER -