Myocardial infarction after GI bleeding ups in-hospital mortality, resource use

A diagnosis of type 1 or type 2 myocardial infarction (MI) following hospitalization for gastrointestinal bleeding (GIB) often leads to higher in-hospital mortality and resource utilization, results of a recent US study have shown.

A team of investigators examined the clinical profiles and prognostic impact of both MI types on outcomes of patients hospitalized with GIB. Patients with GIB and had concomitant diagnoses of type 1 or type 2 MI were identified using the 2018 Nationwide Readmission Database.

Comparisons were then made for baseline characteristics, in-hospital mortality, resource utilization, and 30-day all-cause readmissions among groups.

A total of 381,867 primary GIB hospitalizations were identified, of which 2,902 (0.75 percent) had type 1 MI and 3,963 (1.0 percent) had type 2 MI.

Those with concomitant diagnoses of type 1 and type 2 MI had significantly greater in-hospital mortality than their counterparts without MI (adjusted odds ratio [aOR], 4.72, 95 percent confidence interval [CI], 3.43‒6.48; and aOR, 2.17, 95 percent CI, 1.48‒3.16, respectively).

Both types of MI correlated with higher rates of discharge to a nursing facility (aOR of type 1 MI vs no MI, 1.65, 95 percent CI, 1.45‒1.89; aOR of type 2 vs no MI, 1.37, 95 percent CI, 1.22‒1.54), longer length of stay, higher hospital costs, and more 30-day all-cause readmissions (aOR of type 1 or no MI, 1.22, 95 percent CI, 1.08‒1.38; aOR of type 2 vs no MI, 1.17, 95 percent CI, 1.05‒1.30).

“Types 1 and 2 MI may occur in the setting of GIB,” the investigators said, noting the paucity of data relevant to the prevalence and impact of MI following GIB.