S1328 Seasonal Variations and Peak Hospitalizations Among Patients With Upper Gastrointestinal Bleeding: A Retrospective National Inpatient Sample Database Analysis From 2016-2022

Introduction: Upper gastrointestinal bleeding (UGIB) remains a significant cause of morbidity and hospitalizations in the United States. Previous studies suggest a seasonal component to UGIB incidence, but national-level trends remain underexplored. Our objective is to examine seasonal variation and identify peak hospitalization periods for UGIB using a nationally representative database spanning from 2016 to 2022. Methods: We conducted a retrospective cohort analysis using the National Inpatient Sample (NIS) database from 2016 to 2022. All patients without any age restrictions applied on index hospitalization with a principal diagnosis of UGIB identified using ICD-10-CM codes were included. Monthly and seasonal trends in UGIB admissions were analyzed. Poisson regression was employed to assess the association between seasonality (winter season: December to May) and UGIB admissions, adjusting for overall monthly hospital admissions using an offset. Unweighted and unadjusted datasets were used for trend analysis. Hospitalizations were standardized per 10,000 for generalized linear regression model. Results: A total of 1,310,608 UGIB hospitalizations with a mean age of 65.36 years were identified during the study period. Total unweighted hospitalization for the study period included 48,200,376 patients with a considerably lower mean age (49.75 years). Man to woman ratio for UGIB hospitalizations is almost 1:2. UGIB hospitalizations significantly increased after the onset of COVID-19 pandemic (2020 onwards). A consistent seasonal pattern was observed, with peak UGIB admissions occurring during the winter months (December–May) when compared general all-cause hospitalization rates. Poisson regression analysis revealed a significantly higher incidence rate of UGIB admissions during the winter season compared to the rest of the year (IRR = 1.246, Poisson regression coefficient 4.77 [95% CI: 3.59–5.76], P < 0.001), after adjusting for total admissions. Conclusion: UGIB hospitalizations in the United States demonstrate a clear seasonal pattern, with a significant increase during the December up to May within the last decade. Postulated hypothesis includes nonsteroidal anti-inflammatory drug use for seasonal flu or pneumonia and holiday alcohol consumption during the season. Understanding this variation may help guide resource planning, preventive strategies, and risk mitigation for at-risk populations during peak periods.