Abstract Number: OC 61.5
Meeting: ISTH 2022 Congress
Theme: Acquired Bleeding Disorders » Coagulopathy of Major Bleeding (Trauma, PPH, Vascular/surgical, ECMO, GI bleeding, etc.)
Background: Acute bleeding is common and associated with increased morbidity and mortality. Epidemiological studies evaluating national data on burden, incidence and annual trends in hospitalisations and mortality associated with bleeding sites are valuable yet are lacking.
Aims: To report the burden and incidence of hospitalisation and mortality based on anatomical and ISTH critical site and non-critical site classification, and to review national trends in England.
Methods: A population-based review of people in England between 2014 and 2019 either admitted to an acute care ward, or who died was undertaken. Admitted patients were identified using the Hospital Episode Statistic database. Mortality data and population estimates were obtained from the Office of National Statistics. Bleeding events were selected based on the International Statistical Classification of Diseases version 10 codes. Patients with inherited or acquired coagulation or platelet disorders, and those who were not admitted (emergency department or outpatient clinic) were excluded. Analyses were performed based on anatomical site, critical site and non-critical site ISTH classifications. Annual incidence rates of admissions were calculated as per 100,000 patient years, and deaths per 100, 000 people.
Results: 1,112,873 (34.4%) gastrointestinal, 725,213 (22.4%) genitourinary, 280,003 (8.6%) intracranial and 478,499 (14.7%) obstetric bleeding related hospitalisations were observed during the study period. Intracranial bleeding was associated with the highest mean annual mortality incidence of 15 per 100,000 people. (Figure 1). Hospitalisation for non-critical site bleeding was 5.50 times more common than critical site bleeding (83.4% versus 15.2%, respectively). Mean annual mortality for critical site bleeding was higher than non-critical site bleeding (OR 4.62, CI 4.42-4.82, P < 0.001) (Figure 2).
Conclusion(s): Gastrointestinal bleeding accounted for the highest hospitalisation burden. Intracranial and critical site bleeding are associated with a high mean mortality rate compared to other anatomical sites. Further analysis of these anatomical bleeding classifications is required.
To cite this abstract in AMA style:
Creeper K, Stafford A, Choudhuri S, Tumian N, Breen K, Cohen A. National Incidence of Bleeding-Related Hospitalisations and Mortality by Anatomical and ISTH site classification in England 2014-2019 [abstract]. https://abstracts.isth.org/abstract/national-incidence-of-bleeding-related-hospitalisations-and-mortality-by-anatomical-and-isth-site-classification-in-england-2014-2019/. Accessed April 19, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/national-incidence-of-bleeding-related-hospitalisations-and-mortality-by-anatomical-and-isth-site-classification-in-england-2014-2019/