Evolution of mortality rates due to gastrointestinal bleeding in Peru and its geographic areas, 2003–2022

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BACKGROUND: Gastrointestinal bleeding (GIB) is a common cause of emergency medical admissions and represents a significant public health issue due to its high morbidity and mortality. In Peru, information on mortality rates from GIB disaggregated by region and sex is limited. Therefore, this study aimed to analyze GIB mortality in the country between 2003 and 2022 using official data from the Peruvian Ministry of Health (MINSA). METHODS: An observational, ecological, and descriptive time-series study was conducted using MINSA mortality records for gastrointestinal bleeding from 2003 to 2022. Mortality rates were analyzed by sex and geographical region. Trends were assessed using Poisson regression models in Joinpoint software, identifying significant changes over time. RESULTS: Comparing the first (2003-2007) and last (2018-2022) five-year periods, a shift in the geographic burden was observed in coastal departments such as Ica and La Libertad to highland regions like Huancavelica, Puno, and Huánuco, which reported the highest mortality rates in the most recent period for both sexes. Between 2003 and 2022, GIB mortality rates declined significantly among men in Peru, with an annual percent change (APC) of - 2.2%. In contrast, no significant national trend was observed among women. Regional analysis showed a significant decline in the coastal region for both sexes, while no significant trends were detected in the highland or jungle regions. At the departmental level, three departments (Ica, La Libertad, and Piura) showed significant decreases among men, whereas two departments (Arequipa and La Libertad) showed reductions among women. Notably, Madre de Dios experienced a significant increase in GIB mortality among men. CONCLUSION: Comparing the first (2003-2007) and last (2018-2022) five-year periods, a shift in the geographic burden was observed in coastal departments such as Ica and La Libertad to highland regions like Huancavelica, Puno, and Huánuco, which reported the highest mortality rates in the most recent period for both sexes.

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