Published online Jan 27, 2023. doi: 10.4254/wjh.v15.i1.79
Peer-review started: September 22, 2022
First decision: October 17, 2022
Revised: October 25, 2022
Accepted: November 7, 2022
Article in press: November 7, 2022
Published online: January 27, 2023
Processing time: 116 Days and 4 Hours
With the increasing prevalence, morbidity and mortality of non-alcoholic fatty liver disease (NAFLD), and worse outcomes with concomitant conditions, we wanted to determine the effect of NAFLD on a commonly seen in-patient presentation, non-variceal upper gastrointestinal bleeding (NVUGIB).
There are studies showing the effect of alcoholic liver disease on both variceal and NVUGIB, along with studies showing an increased risk of variceal bleeding and screening in patients with NAFLD. However, there have been no studies showing the influence of NAFLD on NVUGIB. Our aim was to try to bridge this gap.
Our objective was to examine whether the presence of NAFLD led to worse outcomes in patients with NVUGIB.
We used the National Inpatient Sample database to ensure generalizability of findings. We compared the two cohorts of NAFLD with and without NVUGIB on the basis of mortality which was the primary outcome and secondary outcomes such as the length of stay, hospital charges, and complications.
It was shown that patients with NVUGIB and NAFLD had higher odds of mortality, higher hospital charges and more complications such as shock, acute respiratory failure and acute liver failure.
Co-existence of NAFLD and NVUGIB was associated with higher mortality, morbidity and economic burden.
Because of increased morbidity and mortality due to NAFLD, aggressive risk management should be a focus. Also, further studies should be performed to stratify patients with NAFLD that are at higher risk of NVUGIB so that they can be identified by clinicians and the mortality, morbidity and economic burden can be reduced.