Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database

<b>Background:</b> Upper Gastrointestinal Bleed (UGIB) is a common and potentially life-threatening condition with an annual incidence of 80–150 per 100,000 individuals and a mortality rate of 2–10%. Esophagogastroduodenoscopy (EGD) is the gold standard for both diagnosis and treatment,...

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Main Authors: Vignesh Krishnan Nagesh, Vivek Joseph Varughese, Jaber Musalli, Gomathy Aarthy Nageswaran, Erin Russell, Susan Anne Feldman, Simcha Weissman, Adam Atoot
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Medical Sciences
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Online Access:https://www.mdpi.com/2076-3271/13/2/45
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author Vignesh Krishnan Nagesh
Vivek Joseph Varughese
Jaber Musalli
Gomathy Aarthy Nageswaran
Erin Russell
Susan Anne Feldman
Simcha Weissman
Adam Atoot
author_facet Vignesh Krishnan Nagesh
Vivek Joseph Varughese
Jaber Musalli
Gomathy Aarthy Nageswaran
Erin Russell
Susan Anne Feldman
Simcha Weissman
Adam Atoot
author_sort Vignesh Krishnan Nagesh
collection DOAJ
description <b>Background:</b> Upper Gastrointestinal Bleed (UGIB) is a common and potentially life-threatening condition with an annual incidence of 80–150 per 100,000 individuals and a mortality rate of 2–10%. Esophagogastroduodenoscopy (EGD) is the gold standard for both diagnosis and treatment, but post-discharge outcomes, including readmissions, remain underexplored. <b>Methods:</b> This study utilized the 2021 National Readmission Database (NRD) to analyze 30-day readmission rates following EGD for UGIB. Adult patients (≥18 years) admitted for UGIB and undergoing EGD were included; those who died during the index hospitalization were excluded. Demographic, clinical, and socioeconomic factors associated with readmission were examined using multivariate logistic regression. <b>Results:</b> Among 34,257 patients admitted for UGIB and undergoing EGD, 11,088 (32.4%) were readmitted within 30 days, with 5423 (49%) due to recurrent UGIB. Readmitted patients had a higher mean age (68.46 vs. 67.63 years) and greater prevalence of cirrhosis (16.71% vs. 13.84%). Hospital resource utilization was significantly higher among readmissions, with increased total hospital charges (USD 82,544.82 vs. USD 61,521.17) and longer hospital stays (5.38 vs. 4.97 days). Mortality was lower among readmitted patients (1.46% vs. 3.53%). Multivariate analysis identified cirrhosis (OR 7.20, 95% CI: 6.45–8.02), untreated H. pylori infection (OR 3.43, 95% CI: 2.15–4.30), atrial fibrillation (OR 1.52, 95% CI: 1.36–1.69), and chronic antithrombotic therapy (OR 1.63, 95% CI: 1.41–1.89) as significant predictors of recurrent UGIB readmission. Lower socioeconomic status was also associated with increased readmission risk (OR 1.15, 95% CI: 1.05–1.25). <b>Conclusions:</b> Readmission following EGD for UGIB is common and driven primarily by recurrent bleeding. Cirrhosis, untreated H. pylori infection, atrial fibrillation, and chronic anticoagulation therapy are key risk factors. These findings highlight the need for targeted interventions, including improved post-discharge management and optimization of anticoagulation strategies, to reduce readmission rates and improve patient outcomes.
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spelling doaj-art-14e80a9dc8604887a2958cd2e1bcd16f2025-08-20T03:16:22ZengMDPI AGMedical Sciences2076-32712025-04-011324510.3390/medsci13020045Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission DatabaseVignesh Krishnan Nagesh0Vivek Joseph Varughese1Jaber Musalli2Gomathy Aarthy Nageswaran3Erin Russell4Susan Anne Feldman5Simcha Weissman6Adam Atoot7Hackensack Palisades Medical Center, 7600 River Rd, North Bergen, NJ 07047, USAPrisma Health, University of South Carolina, 2 Med Park, Richland, Columbia, SC 29203, USAHackensack Palisades Medical Center, 7600 River Rd, North Bergen, NJ 07047, USAInternal Medicine, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR 72205, USAHackensack Palisades Medical Center, 7600 River Rd, North Bergen, NJ 07047, USAPrisma Health, University of South Carolina, 2 Med Park, Richland, Columbia, SC 29203, USAHackensack Palisades Medical Center, 7600 River Rd, North Bergen, NJ 07047, USAHackensack Palisades Medical Center, 7600 River Rd, North Bergen, NJ 07047, USA<b>Background:</b> Upper Gastrointestinal Bleed (UGIB) is a common and potentially life-threatening condition with an annual incidence of 80–150 per 100,000 individuals and a mortality rate of 2–10%. Esophagogastroduodenoscopy (EGD) is the gold standard for both diagnosis and treatment, but post-discharge outcomes, including readmissions, remain underexplored. <b>Methods:</b> This study utilized the 2021 National Readmission Database (NRD) to analyze 30-day readmission rates following EGD for UGIB. Adult patients (≥18 years) admitted for UGIB and undergoing EGD were included; those who died during the index hospitalization were excluded. Demographic, clinical, and socioeconomic factors associated with readmission were examined using multivariate logistic regression. <b>Results:</b> Among 34,257 patients admitted for UGIB and undergoing EGD, 11,088 (32.4%) were readmitted within 30 days, with 5423 (49%) due to recurrent UGIB. Readmitted patients had a higher mean age (68.46 vs. 67.63 years) and greater prevalence of cirrhosis (16.71% vs. 13.84%). Hospital resource utilization was significantly higher among readmissions, with increased total hospital charges (USD 82,544.82 vs. USD 61,521.17) and longer hospital stays (5.38 vs. 4.97 days). Mortality was lower among readmitted patients (1.46% vs. 3.53%). Multivariate analysis identified cirrhosis (OR 7.20, 95% CI: 6.45–8.02), untreated H. pylori infection (OR 3.43, 95% CI: 2.15–4.30), atrial fibrillation (OR 1.52, 95% CI: 1.36–1.69), and chronic antithrombotic therapy (OR 1.63, 95% CI: 1.41–1.89) as significant predictors of recurrent UGIB readmission. Lower socioeconomic status was also associated with increased readmission risk (OR 1.15, 95% CI: 1.05–1.25). <b>Conclusions:</b> Readmission following EGD for UGIB is common and driven primarily by recurrent bleeding. Cirrhosis, untreated H. pylori infection, atrial fibrillation, and chronic anticoagulation therapy are key risk factors. These findings highlight the need for targeted interventions, including improved post-discharge management and optimization of anticoagulation strategies, to reduce readmission rates and improve patient outcomes.https://www.mdpi.com/2076-3271/13/2/45upper gastrointestinal bleeding (UGIB)esophagogastroduodenoscopy (EGD)national readmission database (NRD)mortalityvariceal bleed
spellingShingle Vignesh Krishnan Nagesh
Vivek Joseph Varughese
Jaber Musalli
Gomathy Aarthy Nageswaran
Erin Russell
Susan Anne Feldman
Simcha Weissman
Adam Atoot
Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
Medical Sciences
upper gastrointestinal bleeding (UGIB)
esophagogastroduodenoscopy (EGD)
national readmission database (NRD)
mortality
variceal bleed
title Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
title_full Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
title_fullStr Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
title_full_unstemmed Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
title_short Readmission Events Following EGD for Upper Gastrointestinal Bleed: An Analysis Using the National Readmission Database
title_sort readmission events following egd for upper gastrointestinal bleed an analysis using the national readmission database
topic upper gastrointestinal bleeding (UGIB)
esophagogastroduodenoscopy (EGD)
national readmission database (NRD)
mortality
variceal bleed
url https://www.mdpi.com/2076-3271/13/2/45
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