Table 2. Trends in age- and sex-specific incidence and hospital costs among patients without atherosclerotic cardiovascular disease on primary prevention aspirin presenting with upper gastrointestinal bleeding, 2016–2020.
ED = emergency department; ppASA = aspirin for primary cardiovascular prevention. P-value is for linear trend.
| Age- and sex-specific incidence of ED visits for upper gastrointestinal bleeding among ppASA users (per 100,000 population) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
|
| |||||||||
| 2016 | 2017 | 2018 | 2019 | 2020 | Change (2016–2020) | P value | Change (2016–2019) | P value | |
|
| |||||||||
| All ages | 7.5 | 8.9 | 9.8 | 10.9 | 10.0 | +29.2% | 0.065 | +39.3% | 0.006 |
| Male | 7.9 | 9.5 | 10.0 | 11.4 | 10.6 | ||||
| Female | 7.2 | 8.3 | 9.2 | 9.7 | 8.9 | ||||
| 45–54 years | 2.5 | 2.6 | 2.9 | 3.1 | 2.6 | +4.8% | 0.438 | +27.1% | 0.013 |
| Male | 3.4 | 3.7 | 3.8 | 4.1 | 3.4 | ||||
| Female | 1.6 | 1.5 | 2.0 | 2.2 | 1.9 | ||||
| 55–64 years | 5.0 | 6.1 | 6.9 | 7.4 | 7.1 | +41.2% | 0.039 | +47.2% | 0.014 |
| Male | 6.2 | 7.8 | 8.9 | 9.7 | 9.2 | ||||
| Female | 3.9 | 4.5 | 5.0 | 5.2 | 5.1 | ||||
| 65–74 years | 9.5 | 11.3 | 12.1 | 14.1 | 13.4 | +41.6% | 0.025 | +49.5% | 0.012 |
| Male | 10.4 | 12.3 | 13.7 | 17.4 | 15.7 | ||||
| Female | 8.7 | 10.4 | 10.7 | 11.3 | 11.4 | ||||
| ≥75 years | 20.4 | 25.3 | 28.5 | 31.6 | 27.7 | +36.0% | 0.111 | +55.2% | 0.007 |
| Male | 19.6 | 24.9 | 25.7 | 29.9 | 27.9 | ||||
| Female | 20.9 | 25.7 | 30.4 | 32.8 | 27.6 | ||||
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| Proportion of patients without atherosclerotic cardiovascular disease on ppASA presenting with upper gastrointestinal bleeding | |||||||||
|
| |||||||||
| All Ages | 10.1% | 11.4% | 12.4% | 12.9% | 12.5% | +23.8% | <0.001 | +27.7% | <0.001 |
| 45–54 years | 4.2% | 4.4% | 4.9% | 5.1% | 4.6% | ||||
| 55–64 years | 7.6% | 8.5% | 9.4% | 9.4% | 9.5% | ||||
| 65–74 years | 13.0% | 14.3% | 14.7% | 15.5% | 14.9% | ||||
| ≥75 years | 16.2% | 18.2% | 20.1% | 21.3% | 20.5% | ||||
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| Proportion of all upper gastrointestinal bleeding hospitalizations for patients on ppASA stratified by Diagnosis-Related Group code* | |||||||||
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| |||||||||
| DRG Code | |||||||||
| 377 | 18.3% | 21.1% | 19.8% | 23.9% | 25.9% | +41.5% | <0.001 | +30.6% | <0.001 |
| 378 | 69.7% | 69.6% | 69.6% | 67.5% | 67.2% | −3.2% | −3.2% | ||
| 379 | 12.0% | 9.3% | 10.6% | 8.6% | 6.9% | −42.5% | <0.001 | −28.3% | <0.001 |
|
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| Nationwide Medicare reimbursements for upper gastrointestinal bleeding hospitalizations in patients on ppASA (in millions) | |||||||||
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| |||||||||
| Total Costs | $51.6 | $74.6 | $83.0 | $97.3 | $86.5 | +67.6% | <0.001 | +88.6% | <0.001 |
| 65–74 years | $31.5 | $45.6 | $50.8 | $59.9 | $54.1 | +71.7% | <0.001 | +90.2% | <0.001 |
| ≥75 years | $20.1 | $29.0 | $32.2 | $37.4 | $32.4 | +61.2% | <0.001 | +86.1% | <0.001 |
*
Diagnosis-Related Group codes correspond to the following: 377 = Gastrointestinal hemorrhage with major complication or comorbidity; 378 = Gastrointestinal hemorrhage with complication or comorbidity; 379 = Gastrointestinal hemorrhage without complication or comorbidity