Risk factors for major gastrointestinal bleeding in the general population in Finland

Table 3 Multivariate analysis for the risk factors for major gastrointestinal bleeding

Variables	Univariate model, HR (95%CI)	Multivariate model, HR (95%CI)
Baseline age (10-yr increase)	1.83 (1.69–1.99)	1.62 (1.42–1.86)
Sex
Male	1	1
Female	0.51 (0.42–0.63)	0.83 (0.59–1.17)
Yr of enrollment
1987	1	1
1992	1.23 (0.83-1.84)	1.15 (0.74–1.79)
1997	2.10 (1.50–2.96)	1.36 (0.91–2.04)
2002	1.72 (1.21–2.43)	1.10 (0.72–1.68)
2007	1.66 (1.15–2.41)	0.90 (0.57–1.43)
Region1
West Finland	1	1
East Finland	0.90 (0.74–1.10)	0.96 (0.77–1.20)
Marital status
Married, cohabiting, or registered partnership	1	1
Single, separated, divorced, or widow	1.29 (1.04–1.59)	1.09 (0.86–1.38)
Occupation
Non-manual (office/studying)	1	1
Manual (factory/ construction/ farming/ forestry)	1.45 (1.06–1.98)	1.25 (0.88–1.78)
Family/ housewife/ pensioner	3.90 (3.06–4.95)	1.26 (0.90–1.75)
Unemployed	2.92 (2.00–4.25)	1.70 (1.11–2.59)
Education2
Low	1	1
Moderate	0.82 (0.64–1.06)	0.81 (0.62–1.06)
High	0.96 (0.76–1.22)	1.05 (0.80–1.38)
Smoking
Never	1	1
Ex-smoker	1.80 (1.43–2.28)	1.18 (0.90–1.53)
Smoker	1.34 (1.05–1.71)	1.30 (0.97–1.74)
Alcohol consumption in grams per week
Non-User	1	1
Mild (0.1 g to 36.9 g)	0.72 (0.54–0.96)	0.88 (0.66–1.19)
Moderate (37 g to 86.9 g)	0.69 (0.51–0.94)	0.76 (0.54–1.06)
Heavy (≥ 87 g)	1.13 (0.88–1.44)	1.02 (0.76–1.37)
Coffee consumption per day, cups
0	1	1
1–5	1.00 (0.71–1.40)	0.72 (0.50–1.02)
6–10	0.72 (0.49–1.06)	0.67 (0.46–0.99)
> 10	0.48 (0.17–1.33)	0.43 (0.23–0.81)
Physical activity
None to Mild	1	1
Moderate to Heavy	0.55 (0.41–0.73)	0.85 (0.62–1.16)
Body mass index standardized	1.38 (1.27–1.50)	1.15 (1.01–1.32)
Waist hip ratio standardized	1.70 (1.55–1.86)	1.18 (0.98–1.43)
Systolic blood pressure standardized	1.30 (1.19–1.42)	0.85 (0.76-0.96)
Diastolic blood pressure standardized	1.24 (1.13–1.37)	-
Total cholesterol standardized	1.10 (1.00–1.21)	0.94 (0.84–1.05)
High density lipoprotein standardized	0.86 (0.77–0.95)	-
Gamma-glutamyl transferase standardized	1.10 (1.08–1.12)	1.05 (1.02-1.09)
Precursors of GIB3
0	1	1
≥ 1	9.44 (7.65–11.65)	1.90 (1.37–2.63)
Any cancer	2.66 (2.03–3.48)	1.47 (1.10–1.97)
Any psychiatric disorders	2.21 (1.77–2.77)	1.32 (1.01–1.71)
Stroke including SAH	2.98 (2.14–4.15)	1.31 (0.90–1.90)
Venous thromboembolism	2.04 (1.26–3.32)	-
Ischemic heart disease	3.14 (2.51–3.94)	1.16 (0.87-1.55)
Valvular heart disease	2.91 (1.91–4.44)	1.40 (0.88-2.25)
Atrial fibrillation	3.46 (2.60–4.60)	1.05 (0.73–1.51)
Peripheral artery disease	3.94 (2.59–6.00)	1.39 (0.87–2.23)
Heart failure	4.35 (3.39–5.58)	1.46 (1.04–2.05)
High blood pressure	1.92 (1.55–2.36)	0.90 (0.69–1.17)
Osteoarthritis	0.78 (0.50–1.23)	0.39 (0.24–0.65)
Connective tissue diseases	1.72 (1.18–2.51)	-
Diabetes4	1.97 (1.47–2.64)	0.76 (0.54–1.08)
Chronic obstructive pulmonary disease	3.57 (2.36–5.39)	1.26 (0.77–2.06)
Asthma	1.19 (0.89–1.58)	0.80 (0.58–1.11)
Liver disorder	6.95 (4.76–10.15)	3.20 (2.06–4.97)
Anemia	7.16 (3.20–16.04)	1.52 (0.48–4.83)

¹West Finland includes Turku and Loimaa as well as Helsinki and Vantaa. East Finland includes North Karelia, North Savo, Oulu, and Lapland.

²Educational tertiles were calculated according to years of education and were specific to the birth cohorts.

³Includes conditions without gastrointestinal bleeding such as gastritis, intestinal diseases, esophageal varices, esophagitis, hemorrhoids, colitis, or Crohn’s disease.

⁴Excluding gestational diabetes.

‘-‘ indicates that the variable was not included in the final multivariate Cox model based on the results from LASSO.

CI: Confidence Interval; GIB: Gastrointestinal bleeding; HR: Hazard ratio; SAH: Subarachnoid hemorrhage.