J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 11, Number 1, January 2019, pages 42-48

Gastrointestinal Bleeding in Patients With Acute Respiratory Distress Syndrome: A National Database Analysis

**Table 1.** Baseline Characteristics and Demographics of ARDS Patients With and Without GIB
Demographics	GIB during hospitalization	P value
Total	145,202	97.33	3,988	2.67
Age group (years)	29,466	99.49	151	0.51	< 0.001
< 20
20 - 39	11,863	98.26	210	1.74
40 - 59	28,252	97.08	850	2.92
60 - 79	43,518	96.49	1,581	3.51
≥ 80	31,917	96.4	1,193	3.6
Age, mean (SD)	53.38 (0.09)	66.58 (0.36)	< 0.001
Race	75,133	97.18	2,184	2.82	< 0.001
White
Black	18,245	97.65	440	2.35
Hispanic	14,666	97.96	305	2.04
Asian or Pacific Islander	2,633	96.31	101	3.69
Native American	840	98.13	16	1.87
Other	3,659	97.31	101	2.69
Gender	75,315	97.47	1,556	2.53	0.008
Female
Male	69,701	97.2	1,591	2.8
Insurance
Medicare	70,326	96.51	2,544	3.49	< 0.001
Medicaid	27,919	98.40	454	1.60
Private insurance	35,970	98.11	693	1.89
Self-pay	5,877	96.96	184	3.04
No charge	640	98.01	13	1.99
Other	4,068	97.86	89	2.14
Hospital type
Rural	21,264	97.85	468	2.15	< 0.001
Urban non-teaching	50,658	97.18	1471	2.82
Urban teaching	72,878	97.28	2,038	2.72
Length of stay, mean (SD)	7.37 (0.03)	11.93 (0.24)	< 0.001
In-hospital mortality, mean (SD)	0.11 (0.00)	0.27 (0.01)	< 0.001
Total charges, mean (SD)	45,951.04 (227.42)	82,812.09 (2,226.03)	< 0.001

Table 1. Baseline Characteristics and Demographics of ARDS Patients With and Without GIB

Demographics

GIB during hospitalization

P value

Yes

No.

Total

145,202

97.33

3,988

2.67

Age group (years)

29,466

99.49

151

0.51

< 0.001

< 20

20 - 39

11,863

98.26

210

1.74

40 - 59

28,252

97.08

850

2.92

60 - 79

43,518

96.49

1,581

3.51

≥ 80

31,917

96.4

1,193

3.6

Age, mean (SD)

53.38 (0.09)

66.58 (0.36)

< 0.001

Race

75,133

97.18

2,184

2.82

< 0.001

White

Black

18,245

97.65

440

2.35

Hispanic

14,666

97.96

305

2.04

Asian or Pacific Islander

2,633

96.31

101

3.69

Native American

840

98.13

1.87

Other

3,659

97.31

101

2.69

Gender

75,315

97.47

1,556

2.53

0.008

Female

Male

69,701

97.2

1,591

2.8

Insurance

Medicare

70,326

96.51

2,544

3.49

< 0.001

Medicaid

27,919

98.40

454

1.60

Private insurance

35,970

98.11

693

1.89

Self-pay

5,877

96.96

184

3.04

No charge

640

98.01

1.99

Other

4,068

97.86

2.14

Hospital type

Rural

21,264

97.85

468

2.15

< 0.001

Urban non-teaching

50,658

97.18

1471

2.82

Urban teaching

72,878

97.28

2,038

2.72

Length of stay, mean (SD)

7.37 (0.03)

11.93 (0.24)

< 0.001

In-hospital mortality, mean (SD)

0.11 (0.00)

0.27 (0.01)

< 0.001

Total charges, mean (SD)

45,951.04 (227.42)

82,812.09 (2,226.03)

< 0.001

**Table 2.** Risk Factors Associated With GIB in Patients With ARDS (CCI: Charlson Comorbidity Index)
Comorbidity	Odds ratio	95% confidence interval	P value
Gastroesophageal reflux disease	0.754	0.669	0.85	< 0.001
Atrial fibrillation	1.549	1.431	1.676	< 0.001
Cirrhosis	8.356	7.414	9.418	< 0.001
Peptic ulcer disease	3.705	3.079	4.458	< 0.001
Rheumatoid arthritis	0.789	0.571	1.09	0.1354
Valvular heart disease	1.08	0.967	1.205	0.1749
Coronary artery disease	1.063	0.982	1.151	0.1325
Hypertension	1.048	0.983	1.118	0.1547
Chronic obstructive pulmonary disorder	1.041	0.96	1.128	0.3415
Diabetes	0.982	0.909	1.06	0.6351
Tobacco use disorder	0.673	0.583	0.777	< 0.001
Pancytopenia	2.624	1.942	3.544	< 0.001
End-stage renal disease	0.876	0.695	1.104	0.2521
Congestive heart failure	1.388	1.298	1.484	< 0.001
Anemia	2.472	2.312	2.644	< 0.001
Peripheral vascular disease	1.304	1.114	1.525	0.0009
TIA/stroke	1.166	1.033	1.316	0.0126
Weekend admission	1.035	0.962	1.114	0.3617
Coagulopathy	3.003	2.738	3.294	< 0.001
Diverticular bleeding	2.742	1.441	5.218	< 0.001
Esophageal cancer	1.23	0.707	2.14	0.4628
Stomach cancer	3.09	2.035	4.692	< 0.001
Colon cancer	1.813	1.431	2.299	< 0.001
CCI index ≥ 2	2.478	2.294	2.677	< 0.001

Table 2. Risk Factors Associated With GIB in Patients With ARDS (CCI: Charlson Comorbidity Index)

Comorbidity

Odds ratio

95% confidence interval

P value

Gastroesophageal reflux disease

0.754

0.669

0.85

< 0.001

Atrial fibrillation

1.549

1.431

1.676

< 0.001

Cirrhosis

8.356

7.414

9.418

< 0.001

Peptic ulcer disease

3.705

3.079

4.458

< 0.001

Rheumatoid arthritis

0.789

0.571

1.09

0.1354

Valvular heart disease

1.08

0.967

1.205

0.1749

Coronary artery disease

1.063

0.982

1.151

0.1325

Hypertension

1.048

0.983

1.118

0.1547

Chronic obstructive pulmonary disorder

1.041

0.96

1.128

0.3415

Diabetes

0.982

0.909

1.06

0.6351

Tobacco use disorder

0.673

0.583

0.777

< 0.001

Pancytopenia

2.624

1.942

3.544

< 0.001

End-stage renal disease

0.876

0.695

1.104

0.2521

Congestive heart failure

1.388

1.298

1.484

< 0.001

Anemia

2.472

2.312

2.644

< 0.001

Peripheral vascular disease

1.304

1.114

1.525

0.0009

TIA/stroke

1.166

1.033

1.316

0.0126

Weekend admission

1.035

0.962

1.114

0.3617

Coagulopathy

3.003

2.738

3.294

< 0.001

Diverticular bleeding

2.742

1.441

5.218

< 0.001

Esophageal cancer

1.23

0.707

2.14

0.4628

Stomach cancer

3.09

2.035

4.692

< 0.001

Colon cancer

1.813

1.431

2.299

< 0.001

CCI index ≥ 2

2.478

2.294

2.677

< 0.001

**Table 3.** Common Etiologies of ARDS and Their Risk for GIB
Cause	Odds ratio	95% confidence interval	P value
Aspiration pneumonia	2.098	1.916	2.296	< 0.001
Pancreatitis	2.016	1.633	2.49	< 0.001
Sepsis	1.622	1.439	1.828	< 0.001
Pneumonia	0.833	0.776	0.894	< 0.001
Burns	0.385	0.096	1.552	0.1797

Table 3. Common Etiologies of ARDS and Their Risk for GIB

Cause

Odds ratio

95% confidence interval

P value

Aspiration pneumonia

2.098

1.916

2.296

< 0.001

Pancreatitis

2.016

1.633

2.49

< 0.001

Sepsis

1.622

1.439

1.828

< 0.001

Pneumonia

0.833

0.776

0.894

< 0.001

Burns

0.385

0.096

1.552

0.1797