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【medical-news】一个多中心研究——非静脉曲张出
CME
Riccardo Marmo, M.D., Maurizio Koch, M.D., Livio Cipolletta, M.D., Lucio Capurso, M.D., Angelo Pera, M.D., Maria A. Bianco, M.D., Rodolfo Rocca, M.D., Angelo Dezi, M.D., Renato Fasoli, M.D., Sergio Brunati, M.D., Ivano Lorenzini, M.D., Ugo Germani, M.D., Giovanni Di Matteo, M.D., Paolo Giorgio, M.D., Giorgio Imperiali, M.D., Giorgio Minoli, M.D., Fausto Barberani, M.D., Sandro Boschetto, M.D., Marco Martorano, M.D., Giovanni Gatto, M.D., Mariano Amuso, M.D., Alfredo Pastorelli, M.D., Elena S. Torre, M.D., Omero Triossi, M.D., Andrea Buzzi, M.D., Renzo Cestari, M.D., Domenico Della Casa, M.D., Massimo Proietti, M.D., Anna Tanzilli, M.D., Giovanni Aragona, M.D., Francesco Giangregorio, M.D., Luciano Allegretta, M.D., Salvatore Tronci, M.D., Paolo Michetti, M.D., Paola Romagnoli, M.D., Andrea Nucci, M.D., Francesca Rogai, M.D., Walter Piubello, M.D., Maria Tebaldi, M.D., Fabrizio Bonfante, M.D., Alessandro Casadei, M.D., Claudio Cortini, M.D., Giorgio Chiozzini, M.D., Lisa Girardi, M.D., Claudio Leoci, M.D., Giampiero Bagnalasta, M.D., Sergio Segato, M.D., Giuseppe Chianese, M.D., Mario Salvagnini, M.D., Gianluca Rotondano, M.D. –
Reprint requests and correspondence: Riccardo Marmo, M.D., Division of Gastroenterology, Hospital "L.Curto," Polla, Via Sottobraida 32, 84037 Sant'Arsenio, Italy.
Copyright © 2008 American College of Gastroenterology/Blackwell Publishing
(Am J Gastroenterol 2008;103:1639–1647)
ABSTRACT
OBJECTIVES: From an Italian Registry of patients with upper gastrointestinal hemorrhage (UGIH), we assessed the clinical outcomes and explored the roles of clinical, endoscopic, and therapeutic factors on 30-day mortality in a real life setting.
METHODS: Prospective analysis of consecutive patients endoscoped for UGIH at 23 community and tertiary care institutions from 2003 to 2004. Covariates and outcomes were defined a priori and 30-day follow-up obtained. Logistic regression analysis identified predictors of mortality.
RESULTS: One thousand and twenty patients were included. A total of 46 patients died for an overall 4.5% mortality rate. In all, 85% of deaths were associated with one or more major comorbidity. Sixteen of 46 patients (35%) died within the first 24 h of the onset of bleeding. Of these, eight had been categorized as ASA class 1 or 2 and none of them was operated upon, despite a failure of endoscopic intention to treatment in four. Regression analysis showed advanced age, presence of severe comorbidity, low hemoglobin levels at presentation, and worsening health status as the only independent predictors of 30-day mortality (P < 0.001). The acute use of a PPI exerted a protective effect (OR 0.23, 95% CI 0.09–0.73). Recurrent bleeding was low (3.2%). Rebleeders accounted for only 11% of the total patients deceased (OR 3.27, 95% CI 1.5–11.2).
CONCLUSIONS: These results indicate that 30-day mortality for nonvariceal bleeding is low. Deaths occurred predominantly in elderly patients with severe comorbidities or those with failure of endoscopic intention to treatment.
-------------------------------------------------------------------------------- Title：Predictive Factors of Mortality From Nonvariceal Upper Gastrointestinal Hemorrhage: A Multicenter Study
题目：非曲张静脉的上消化道出血死亡的预测因子。
Authors： Riccardo Marmo, M.D., et al.
通讯作者：Riccardo Marmo医生, "L.Curto"医院消化科，Polla, Via Sottobraida 32, 84037 Sant'Arsenio,意大利
Resource: Am J Gastroenterol 2008;103:1639–1647
来源: 美国胃肠病杂志 2008;103:1639–1647
ABSTRACT
摘要
OBJECTIVES: From an Italian Registry of patients with upper gastrointestinal hemorrhage (UGIH), we assessed the clinical outcomes and explored the roles of clinical, endoscopic, and therapeutic factors on 30-day mortality in a real life setting.
目的：来自意大利登记中心的上消化道出血（UGIH）病人，我们评估该系统的临床结果，探讨临床、内镜和治疗因素对于30天死亡率的作用。
METHODS: Prospective analysis of consecutive patients endoscoped for UGIH at 23 community and tertiary care institutions from 2003 to 2004. Covariates and outcomes were defined a priori and 30-day follow-up obtained. Logistic regression analysis identified predictors of mortality.
方法：前瞻分析2003年到2004年间23个社区和三甲医疗机构中内镜检查的连续病人。共变量和结果定义为之前和获得的30天随访结果。逻辑回归分析确定死亡的预测因子。
RESULTS: One thousand and twenty patients were included. A total of 46 patients died for an overall 4.5% mortality rate. In all, 85% of deaths were associated with one or more major comorbidity. Sixteen of 46 patients (35%) died within the first 24 h of the onset of bleeding. Of these, eight had been categorized as ASA class 1 or 2 and none of them was operated upon, despite a failure of endoscopic intention to treatment in four. Regression analysis showed advanced age, presence of severe comorbidity, low hemoglobin levels at presentation, and worsening health status as the only independent predictors of 30-day mortality (P < 0.001). The acute use of a PPI exerted a protective effect (OR 0.23, 95% CI 0.09–0.73). Recurrent bleeding was low (3.2%). Rebleeders accounted for only 11% of the total patients deceased (OR 3.27, 95% CI 1.5–11.2).
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作者:admin@医学,生命科学 2011-08-13 05:14
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