Secondary angiodysplasia-associated gastrointestinal bleeding in end-stage renal disease: Results from the nationwide inpatient sample

Table 1 Prevalence and distribution of demographics, severity of disease, and covariate of patients hospitalized with a diagnosis of end-stage renal disease and angiodysplasia associated-gastrointestinal bleeding in end-stage renal disease hospitalizations, 2009-2014

	End-stage renal disease hospitalizations (n = 5505252), n (%)	End-stage renal disease with angiodysplasia associated-gastrointestinal bleeding (n = 24709), n (%)	End-stage renal disease withoutangiodysplasia (n = 5480543), n (%)	P value
Year
2009	876373 (15.92)	2886 (0.33)	873488 (99.67)	< 0.0001
2010	905614 (16.45)	3845 (0.42)	901768 (99.58)
2011	975245 (17.72)	4273 (0.44)	970972 (99.56)
2012	911325 (16.55)	4450 (0.49)	906875 (99.51)
2013	909080 (16.51)	4715 (0.52)	904365 (99.48)
2014	927615 (16.85)	4540 (0.49)	923075 (99.51)
Sex
Female	2598705 (47.20)	11792 (0.45)	2586913 (99.55)	0.5452
Male	2906547 (52.80)	12917 (0.44)	2893630 (99.56)
Age category
18-44	805556 (14.63)	646 (0.08)	804909 (99.92)	< 0.0001
45-64	2215958 (40.25)	7632 (0.34)	2208326 (99.66)
65-74	1266923 (23.02)	7996 (0.63)	1258927 (99.37)
75+	1216815 (22.10)	8435 (0.69)	1208381 (99.31)
Race/ethnicity
Caucasian	2179234 (39.58)	10509 (0.48)	2168725 (99.52)	0.0149
African American	1776081 (32.26)	8051 (0.45)	1768030 (99.55)
Hispanic	796930 (14.48)	3240 (0.41)	793690 (99.59)
Asian Pacific Islander	174118 (3.16)	610 (0.35)	173507 (99.65)
Native American	53624 (0.98)	188 (0.35)	53436 (99.65)
Others/Unknown	525265 (9.54)	2111 (0.40)	523155 (99.60)
Primary payor
Self-Payor	86637 (1.58)	78 (0.09)	86559 (99.91)	< 0.0001
Private Payor	606394 (11.01)	2114 (0.35)	604280 (99.65)
Medicaid	595160 (10.81)	1528 (0.26)	593632 (99.74)
Medicare	4114876 (74.74)	20728 (0.50)	4094148 (99.50)
Others/Unknown	102185 (1.86)	261 (0.26)	101924 (99.74)
Median Household Income Quartile
1st Quartile (Lowest)	2042427 (37.10)	9105 (0.45)	2033322 (99.55)	0.2426
2nd Quartile	1344796 (24.43)	5844 (0.43)	1338952 (99.57)
3rd Quartile	1147171 (20.84)	5170 (0.45)	1142001 (99.55)
4th Quartile (Highest)	831706 (15.11)	4052 (0.49)	827653 (99.51)
Unknown	139152 (2.52)	538 (0.39)	138615 (99.61)
Charlson-Deyo Comorbidity Index
Score 1-2	1024375 (18.61)	3617 (0.35)	1020758 (99.65)	< 0.0001
Score 3-4	2918273 (53.01)	13289 (0.46)	2904984 (99.54)
Score 5+	1562604 (28.38)	7803 (0.50)	1554801 (99.50)
Hypertension
Yes	4234181 (76.91)	21756 (0.51)	4212425 (99.49)	< 0.0001
No	1271071 (23.09)	2953 (0.23)	1268118 (99.77)
Diabetes mellitus
Yes	3119720 (56.67)	13648 (0.44)	3106072 (99.56)	0.1309
No	2385532 (43.33)	11061 (0.46)	2374471 (99.54)
Tobacco use
Yes	1124816 (20.43)	6004 (0.53)	1118812 (99.47)	< 0.0001
No	4380436 (79.57)	18705 (0.43)	4361731 (99.57)
Obesity
Yes	642352 (11.67)	2569 (0.40)	639783 (99.60)	0.1030
No	4862900 (88.33)	22140 (0.46)	4840760 (99.54)
Hospital location/teaching status
Rural	362509 (6.58)	1419 (0.39)	361090 (99.61)	0.1437
Urban Nonteaching	2047397 (37.19)	8858 (0.43)	2038539 (99.57)
Urban Teaching	3053214 (55.46)	14248 (0.47)	3038965 (99.53)
Unknown	42132 (0.77)	184 (0.44)	41949 (99.56)
Hospital region
Northeast	993923 (18.06)	4742 (0.48)	989181 (99.52)	0.1104
Midwest	1149456 (20.88)	5388 (0.47)	1144068 (99.53)
South	2289246 (41.58)	10245 (0.45)	2279002 (99.55)
West	1072627 (19.48)	4334 (0.40)	1068292 (99.60)

Table 2 Multivariable analyses of factors associated with Angiodysplasia associated-gastrointestinal bleeding in end-stage renal disease hospitalizations, 2009-2014

	Adjusted odds ratio (95%CI)	P value
Year
2010	1.27 (1.07, 1.52)	0.0071
2011	1.28 (1.08, 1.53)	0.0045
2012	1.43 (1.23, 1.66)	< 0.0001
2013	1.51 (1.30, 1.76)	< 0.0001
2014	1.39 (1.19, 1.61)	< 0.0001
2009	Reference
Sex
Male	0.99 (0.93, 1.06)	0.8053
Female	Reference
Age category
45-64	4.12 (3.05, 5.57)	< 0.0001
65-74	7.42 (5.27, 10.4)	< 0.0001
75+	8.22 (5.87, 11.5)	< 0.0001
18-44	Reference
Race/ethnicity
African American	1.12 (1.02, 1.23)	0.0206
Asian Pacific Islander	0.77 (0.62, 0.96)	0.0194
Hispanic	1.08 (0.89, 1.30)	0.4459
Native American	0.93 (0.61, 1.42)	0.7335
Others/unknown	0.98 (0.86, 1.12)	0.7289
Caucasian	Reference
Primary payor
Others/Unknown	0.69 (0.52, 0.90)	0.0072
Medicaid	0.84 (0.69, 1.01)	0.0669
Private Payor	0.96 (0.83, 1.10)	0.5551
Self-Payor	0.32 (0.20, 0.51)	< 0.0001
Medicare	Reference
Median Household Income Quartile
2nd Quartile	0.96 (0.86, 1.06)	0.4205
3rd Quartile	0.97 (0.88, 1.08)	0.6124
4th Quartile (Highest)	1.00 (0.89, 1.12)	0.9335
Unknown	0.96 (0.76, 1.20)	0.7065
1st Quartile (Lowest)	Reference
Charlson-Deyo Comorbidity Index
Score 3-4	1.15 (1.04, 1.27)	0.0047
Score 5+	1.26 (1.12, 1.43)	0.0002
Score 1-2	Reference
Hypertension
Yes	2.01 (1.79, 2.26)	< 0.0001
No	Reference
Diabetes mellitus
Yes	0.79 (0.73, 0.85)	< 0.0001
No	Reference
Tobacco use
Yes	1.26 (1.17, 1.36)	< 0.0001
No	Reference
Hospital location/teaching status
Rural	0.78 (0.66, 0.93)	0.0057
Unknown	1.20 (0.77, 1.86)	0.4205
Urban Nonteaching	0.89 (0.80, 0.98)	0.0160
Urban Teaching	Reference
Hospital region
Midwest	0.99 (0.89, 1.10)	0.8082
Northeast	0.97 (0.85, 1.10)	0.6453
West	0.93 (0.80, 1.09)	0.3770
South	Reference

Table 3 Comparison between inpatient mortality, mean hospitalization cost of care, and mean length of stay between end-stage renal disease and angiodysplasia associated-gastrointestinal bleeding, and end-stage renal disease hospitalizations, 2009-2014

	Mortality		Total charges		Length of stay
	Odds ratio (95%CI)	P value	Difference (95%CI)	P value	Difference (95%CI)	P value
Angiodysplasia	0.67 (0.58, 0.78)	< 0.0001	$17761 ($12550, $22973)	< 0.0001	1.86 (1.40, 2.32)	< 0.0001
No Angiodysplasia	Reference		Reference		Reference