P0932 - Shielding Effects of Antiplatelets on Hospital Outcomes in Non-Variceal Upper Gastrointestinal Bleeding

Omar Oudit, DO¹, Javed Jagroo, MBBS², Jamal Perry, MD¹, Kibwey Peterkin, MD³, Corey Knowles, MD³, Sravani Bhavanam, ⁴, Vinay Chandramouli Bellur, ⁵
1Brookdale University Hospital Medical Center, Brooklyn, NY; 2Brookdale University Hospital Medical Center, Ozone Park, NY; 3One Brooklyn Health-Brookdale University Hospital Medical Center, Brooklyn, NY; 4Brookdale University Hospital Medical Center, Bangalore, Karnataka, India; 5Ramaiah medical college, Bangalore, Karnataka, India

Introduction: To investigate the potential effects of aspirin use on in hospital metrics and clinical outcomes who were admitted with a principal diagnosis of non-variceal upper gastrointestinal bleeding, NVUGB.

Methods: The Nationwide Inpatient Sample, NIS, database from 2017 to 2022 was analyzed for patients age >18 years who were hospitalized with a principal diagnosis of non-variceal upper gastrointestinal bleeding using ICD-10 diagnostic codes. Multivariate logistic regression was applied to the outcomes. The Charlson Comorbidity Index was used to adjust for confounders. A p-value (pv) of < 0.05 was considered statistically significant. The principal outcome of this investigation is in-hospital mortality, with secondary outcomes including length of stay, LOS, total hospital charges, THC, and likelihood of developing hospital complications.

Results: The proportion of hospitalized patients with NVUGB who did not use aspirin and died was measured to be 2.14% as compared to 1.06% with aspirin use (P< 0.0001). Aspirin use was identified to have a significantly reduced odds of in-patient mortality (adjusted odds ratio [aOR] 0.433, 95% confidence interval [CI] 0.395-0.475; P< 0.0001). Patients with aspirin use experienced a shorter, LOS, (1.84 days, 95% CI: -0.863 – -0.776, P< 0.0001) vs 2.66 days without aspirin use, decreased, THC, (-$11431.31, 95% CI: -$12,135.47 to -$10,727.15, P=0.000). Furthermore, patients with concurrent aspirin use also demonstrated significantly reduced odds of requiring hemodynamic support with vasopressors in setting of NVUGB (aOR 0.67, 95% CI: 0.6039 - 0.7518, P< 0.001) and experienced decreased odds of requiring an ICU level of care (aOR 0.59, 95% CI: 0.564 to 0.625, P< 0.001).

Discussion: Patients admitted with NVUGB with concurrent use of the antiplatelet agent aspirin demonstrated a significantly reduced risk of in-hospital mortality, reduced risk of mortality greater than 56%. Aspirin use in the setting of NVUGIB was further linked to decreased LOS and reduced total hospital charges with a significant reduction in odds of developing hemodynamic instability necessitating pressor support and/or ICU level monitoring. These findings reveal that aspirin exerts shielding protective effects against adverse in-hospital outcomes as compared to patients with NVUGB and no concurrent aspirin use.

Disclosures:
Omar Oudit indicated no relevant financial relationships.
Javed Jagroo indicated no relevant financial relationships.
Jamal Perry indicated no relevant financial relationships.
Kibwey Peterkin indicated no relevant financial relationships.
Corey Knowles indicated no relevant financial relationships.
Sravani Bhavanam indicated no relevant financial relationships.
Vinay Chandramouli Bellur indicated no relevant financial relationships.

Omar Oudit, DO¹, Javed Jagroo, MBBS², Jamal Perry, MD¹, Kibwey Peterkin, MD³, Corey Knowles, MD³, Sravani Bhavanam, ⁴, Vinay Chandramouli Bellur, ⁵. P0932 - Shielding Effects of Antiplatelets on Hospital Outcomes in Non-Variceal Upper Gastrointestinal Bleeding, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.