Influence of non-alcoholic fatty liver disease on non-variceal upper gastrointestinal bleeding:A nationwide analysis  

作　　者：Aakriti Soni Anuroop Yekula Yuvaraj Singh Nitish Sood Dushyant Singh Dahiya Kannu Bansal GM Abraham 

机构地区：[1]Department of Internal Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States [2]Department of Internal Medicine,Medical College of Georgia,Augusta University,Augusta,GA 30912,United States [3]Department of Internal Medicine,Central Michigan University,Saginaw,MI 48602,United States

出　　处：《World Journal of Hepatology》2023年第1期79-88,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the leading cause of liver disease globally with an estimated prevalence of 25%,with the clinical and economic burden expected to continue to increase.In the United States,non-variceal upper gastrointestinal bleeding(NVUGIB)has an estimated incidence of 61-78 cases per 100000 people with a mortality rate of 2%-15%based on co-morbidity burden.AIM To identify the outcomes of NVUGIB in NAFLD hospitalizations in the United States.METHODS We utilized the National Inpatient Sample from 2016-2019 to identify all NVUGIB hospitalizations in the United States.This population was divided based on the presence and absence of NAFLD.Hospitalization characteristics,outcomes and complications were compared.RESULTS The total number of hospitalizations for NVUGIB was 799785,of which 6%were found to have NAFLD.NAFLD and GIB was,on average,more common in younger patients,females,and Hispanics than GIB without NAFLD.Interestingly,GIB was less common amongst blacks with NAFLD.Multivariate logistic regression analysis was conducted,controlling for the multiple covariates.The primary outcome of interest,mortality,was found to be significantly higher in patients with NAFLD and GIB[adjusted odds ratio(aOR)=1.018(1.013-1.022)].Secondary outcomes of interest,shock[aOR=1.015(1.008-1.022)],acute respiratory failure[aOR=1.01(1.005-1.015)]and acute liver failure[aOR=1.016(1.013-1.019)]were all more likely to occur in this cohort.Patients with NAFLD were also more likely to incur higher total hospital charges(THC)[$2148($1677-$2618)];however,were less likely to have a longer length of stay[0.27 d(0.17-0.38)].Interestingly,in our study,the patients with NAFLD were less likely to suffer from acute myocardial infarction[aOR=0.992(0.989-0.995)].Patients with NAFLD were not more likely to suffer acute kidney injury,sepsis,blood transfusion,intubation,or dialysis.CONCLUSION NVUGIB in NAFLD hospitalizations had higher inpatient mortality,THC,and complications such as shock,acute respiratory failure,

关 键 词：Non-alcoholic fatty liver disease Non-variceal gastrointestinal bleeding OUTCOMES MORTALITY COMPLICATIONS 

分 类 号：R575.5[医药卫生—消化系统]