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Palliative care documentation in gastrointestinal bleeding hospitalizations: national trends and associated care patterns
Akram Alnounou, Brian Nohomovich, Mohammad Alabbas, Kirsten Hickok, Fnu Vikash, Rutwik Sharma, Neil Sengupta, Basile M. Njei et al.. Baylor University Medical Center Proceedings, 2026-08-10
Topic: Risk, prevention and care in population studies
Among 2,435,099 weighted hospitalizations, palliative care documentation was present in 65,675 (2.70%), increasing from 2.13% in 2016 to 3.43% in 2022. Associated factors included metastatic cancer (adjusted odds ratio [aOR], 8.276), age ≥85 years (aOR, 5.626), respiratory failure (aOR, 3.159), and dementia (aOR, 3.101). Relative to the White category, Black (aOR, 0.802) and Hispanic (aOR, 0.791) categories had lower adjusted odds. Documentation was associated with lower odds of endoscopy but higher odds of mechanical ventilation and renal replacement therapy. Among in-hospital decedents, coded do-not-resuscitate status was more frequent (80.2% vs 40.5%), and several treatments were less frequent. Adjusted length of stay and hospital charges were 4.3% and 1.1% higher, respectively. Palliative care documentation was uncommon and concentrated in higher-acuity hospitalizations. Because the code does not identify provider specialty, timing, or content, patterns are associations rather than effects and require validation in clinically richer data.
Key findings
- Among 2,435,099 weighted hospitalizations, palliative care documentation was present in 65,675 (2.70%), increasing from 2.13% in 2016 to 3.43% in 2022.
- Associated factors included metastatic cancer (adjusted odds ratio [aOR], 8.276), age ≥85 years (aOR, 5.626), respiratory failure (aOR, 3.159), and dementia (aOR, 3.101).
- Relative to the White category, Black (aOR, 0.802) and Hispanic (aOR, 0.791) categories had lower adjusted odds.
- Documentation was associated with lower odds of endoscopy but higher odds of mechanical ventilation and renal replacement therapy.
- Among in-hospital decedents, coded do-not-resuscitate status was more frequent (80.2% vs 40.5%), and several treatments were less frequent.
Why it matters
This cross-sectional analysis of gastrointestinal bleeding hospitalizations found palliative care documentation was uncommon and concentrated in higher-acuity hospitalizations, with dementia among associated factors. The authors note patterns are associations rather than effects and require validation in clinically richer data.
Study details
- Study designcross-sectional
- Effect size2.70%; 2.13%; 3.43%
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Baylor University Medical Center Proceedings) |
| Journal's citation record | 0 / 4 | Baylor University Medical Center Proceedings: journal h-index 63 (OpenAlex, 2026-10-29) |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 6.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Eric Martin Sieloff: h-index 6 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 11 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42573200) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Alnounou, A., Nohomovich, B., Alabbas, M., Hickok, K., Vikash, F., Sharma, R., et al. (2026). Palliative care documentation in gastrointestinal bleeding hospitalizations: national trends and associated care patterns. Baylor University Medical Center Proceedings. https://doi.org/10.1080/08998280.2026.2712806
Vancouver
Alnounou A, Nohomovich B, Alabbas M, Hickok K, Vikash F, Sharma R, et al. Palliative care documentation in gastrointestinal bleeding hospitalizations: national trends and associated care patterns. Baylor University Medical Center Proceedings. 2026. doi:10.1080/08998280.2026.2712806. PMID: 42573200.
BibTeX
@article{alnounou2026-42573200,
author = {Alnounou, Akram and Nohomovich, Brian and Alabbas, Mohammad and Hickok, Kirsten and Vikash, Fnu and Sharma, Rutwik and Sengupta, Neil and Njei, Basile M. and others},
title = {{Palliative care documentation in gastrointestinal bleeding hospitalizations: national trends and associated care patterns}},
journal = {Baylor University Medical Center Proceedings},
year = {2026},
doi = {10.1080/08998280.2026.2712806},
pmid = {42573200},
url = {https://doi.org/10.1080/08998280.2026.2712806}
}
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