P2460 - The Impact of Congestive Heart Failure on Gastrointestinal Bleeding and Its Clinical Outcomes: A Population-Based Study Using Propensity Matched Analysis

Waqas Rasheed, MD¹, Muhammad Imtanan Fazal, MD², Hassam Ali, MD³, Umar Hayat, MD⁴, Amna Iqbal, MD⁵, Mona A.. Ali, MD⁶, Gnanashree Dharmarpandi, MD⁷, Sherif E.. Elhanafi, MD^8
1University of Kentucky, Lexington, KY; ²Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; ³East Carolina University Brody School of Medicine, Greenville, NC; ⁴Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; ⁵University of Toledo Medical Center, Toledo, OH; ⁶Mansoura University, Mansoura, Ad Daqahliyah, Egypt; ⁷Texas Tech University Health Sciences Center, Amarillo, TX; ⁸Texas Tech University Health Sciences Center, El Paso, TX

Introduction: Gastrointestinal bleeding (GIB) is a significant cause of hospitalization in the US. Patients with congestive heart failure (CHF) could be at a higher risk, particularly due to the increased use of anticoagulants and antiplatelet agents. However, the impact of CHF on inpatient outcomes of GIB remains unknown.

Methods: The data were sourced from the TriNetX US Collaborative Network database (2000-2024). Adult patients (age ≥18 years) hospitalized with a primary diagnosis of upper gastrointestinal bleeding (UGIB) or lower gastrointestinal bleeding (LGIB) were included. The patients were stratified based on the presence of CHF. Small intestinal bleeding patients were not included in this study due to the unavailability of specific diagnostic codes. Propensity score matching (1:1) was performed to match the patients with CHF to those without CHF. The matching was based on demographics, cerebrovascular diseases, cirrhosis, chronic kidney disease, chronic ischemic heart disease, and the use of antiplatelet therapy (APT) and anticoagulant therapy (ACT). The outcomes were analyzed within the first two weeks of hospitalization to enhance the likelihood of capturing inpatient results.

Results: A total of 40,856 patients were identified. Patients with UGIB were 20,548, and those with LGIB were 20,308. CHF was identified in 4,681 (22.78%) patients in the UGIB group and 3,800 (18.71%) patients in the LGIB group. In the UGIB cohort, there was no significant increase in mortality in the CHF cohort compared to the non-CHF cohort (Odds ratio (OR) 0.845, 95% confidence interval (CI) 0.684-1.044, P-value=0.1186). However, in the LGIB group, the CHF cohort was noted to have higher mortality compared to the non-CHF cohort (OR=2.050, 95% CI 1.339-3.139, P-value=0.0007). Additionally, the presence of CHF was associated with an increased need for critical care services, higher odds of hypovolemic/hemorrhagic shock, acute kidney injury, and a greater need for blood transfusion and endoscopic intervention for hemostasis in both the UGIB and LGIB groups (Table 1). The results remained statistically significant with and without adjustment for the use of APT and ACT.

Discussion: In this population-based study, CHF was associated with higher mortality in patients with LGIB; however, no increase in mortality was observed in UGIB patients, regardless of APT or ACT use. This highlights the need for tailored approaches in managing these critical patients.


Disclosures:


Waqas Rasheed, MD¹, Muhammad Imtanan Fazal, MD², Hassam Ali, MD³, Umar Hayat, MD⁴, Amna Iqbal, MD⁵, Mona A.. Ali, MD⁶, Gnanashree Dharmarpandi, MD⁷, Sherif E.. Elhanafi, MD⁸. P2460 - The Impact of Congestive Heart Failure on Gastrointestinal Bleeding and Its Clinical Outcomes: A Population-Based Study Using Propensity Matched Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.