Changing trends in the clinical characteristics of gastrointestinal bleeding among hospitalized patients from 2012-2024 in China: a retrospective study.

Abstract

Gastrointestinal bleeding (GIB) remains a critical medical emergency with rising healthcare burdens in China. This study aimed to analyze its epidemiological shifts and risk factors over the past decade. A retrospective analysis included 3,523 inpatients with GIB at Renji Hospital (2012-2024), stratified into two periods: 2012-2019 (n = 2,024) and 2020-2024 (n = 1,499). Temporal trends were assessed with Student's t-tests, Mann-Whitney U test and Pearson's χ² tests and further verified by Bayesian age-period-cohort modeling. The mean age increased from 56.35 to 58.05 years (P < 0.01), while the median of hospital stay decreased from 9 to 7 days (P < 0.01). The age distribution shifted toward older population, with a decline in the 40-59 years group (from 30.09% to 26.68%; P = 0.03) and a rise in the 60-79 years group (from 41.50% to 46.96%; P < 0.01). Etiologies of GIB also evolved: the proportions of peptic ulcer disease and variceal bleeding decreased significantly, whereas cases of inflammatory bowel disease and post-endoscopic bleeding increased (all P < 0.01). Concurrently, antithrombotic use rose from 13.29% to 20.08% (P < 0.01), accompanied by higher prevalence of comorbidities such as cerebral infarction and coronary heart disease (P < 0.01). Our findings illustrate a rapidly evolving GIB landscape in China, characterized by an aging patient profile, changing etiology, and rising antithrombotic use. These changes, likely driven by demographic aging and evolving clinical practices, underscore the need for updated management protocols-including enhanced bleeding risk assessment in elderly patients, standardized peri‑endoscopic care, and dynamic resource allocation-to address the growing complexity of GIB cases.