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• W4377012023 abstract "Patients with end-stage renal disease (ESRD) have a five times higher risk of gastrointestinal bleed (GIB) and mortality than the general population. Aortic stenosis (AS) has been associated with GIB from intestinal angiodysplasia. In this retrospective analysis, we obtained data from the 2012 and 2019 National Inpatient Sample. The primary outcome of interest was all-cause in-hospital mortality and risk factors of mortality in patients with ESRD with GIB with aortic valve disorders especially AS. We identified all patients (≥18 years of age) with ESRD ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M1> <mi>n</mi> <mo>=</mo> <mn>1,707,452</mn> </math> ) and analyzed based on discharge diagnosis of valvular heart disease ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M2> <mi>n</mi> <mo>=</mo> <mn>6521</mn> </math> ) in patients with GIB compared with those without GIB ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M3> <mi>n</mi> <mo>=</mo> <mn>116,560</mn> </math> ). Survey statistical methods accounting for strata and weighted data were used for analysis using survey packages in R (version 4.0). Baseline categorical data were compared using Rao-Scott chi square test, and continuous data were compared using Student’s t-test. Covariates were assessed using univariate regression analysis, and factors with <math xmlns=http://www.w3.org/1998/Math/MathML id=M4> <mi>p</mi> </math> value less than 0.1 in the univariate analysis were entered in the final model. The univariate and multivariable associations of presumed risk factors of mortality in ESRD with GIB patients were performed by Cox proportional hazards model censored at length of stay. Propensity score matching was done using MatchIt package in R (version 4.3.0). 1 : 1 nearest neighbour matching was done with propensity scores estimated through logistic regression, in which occurrence of GIB, valvular lesions, and AS was regressed according to other patient characteristics. Among patients with ESRD with valvular heart diseases, AS was found to be associated with increased risk of GIB ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M5> <mtext>adj</mtext> <mo>.</mo> <mtext>OR</mtext> <mo>=</mo> <mn>1.005</mn> </math> ; 95% CI 1.003–1.008; <math xmlns=http://www.w3.org/1998/Math/MathML id=M6> <mi>p</mi> <mo><</mo> <mn>0.01</mn> </math> ). ESRD patients with AS showed increased risk of lower GIB ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M7> <mtext>OR</mtext> <mo>=</mo> <mn>1.04</mn> </math> ; 95% CI 1.01–1.06; <math xmlns=http://www.w3.org/1998/Math/MathML id=M8> <mi>p</mi> <mo>=</mo> <mn>0.02</mn> </math> ), colonic angiodysplasia ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M9> <mtext>OR</mtext> <mo>=</mo> <mn>1.03</mn> </math> ; 95% CI 1.01–1.05; <math xmlns=http://www.w3.org/1998/Math/MathML id=M10> <mi>p</mi> <mo><</mo> <mn>0.01</mn> </math> ), stomach and duodenal angiodysplasia ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M11> <mtext>OR</mtext> <mo>=</mo> <mn>1.03</mn> </math> ; 95% CI 1.02–1.06; <math xmlns=http://www.w3.org/1998/Math/MathML id=M12> <mi>p</mi> <mo><</mo> <mn>0.01</mn> </math> ), need for blood transfusion add pressors as compared to those without AS. However, there was no increased risk of mortality ( <math xmlns=http://www.w3.org/1998/Math/MathML id=M13> <mtext>OR</mtext> <mo>=</mo> <mn>0.97</mn> </math> ; 95% CI 0.95–0.99; <math xmlns=http://www.w3.org/1998/Math/MathML id=M14> <mi>p</mi> <mo><</mo> <mn>0.01</mn> </math> )." @default.
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• W4377012023 date "2023-05-08" @default.
• W4377012023 modified "2023-09-27" @default.
• W4377012023 title "Risk of Gastrointestinal Bleeding in Patients with End-Stage Renal Disease: The Link between Gut, Heart, and Kidneys" @default.
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• W4377012023 doi "https://doi.org/10.1155/2023/9986157" @default.
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