Moayyedi P, Burch N, Akhtar-Danesh N, Enaganti S K, Harrison R, Talley N J, Jankowski J
Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Aliment Pharmacol Ther. 2008 Feb 15;27(4):316-20. doi: 10.1111/j.1365-2036.2007.03582.x. Epub 2007 Dec 6.
Patients with Barrett's oesophagus are at increased risk of oesophageal adenocarcinoma. Observational studies have suggested increase in overall mortality also but data are conflicting.
To assess the cause of death in patients with Barrett's oesophagus compared with the general population.
Patients with Barrett's oesophagus were identified retrospectively in four hospitals in Leicestershire, UK using electronic endoscopy and histopathology records from 1997 to 2003. Data on deaths from this cohort of patients were identified through the Office of National Statistics and compared with age- and gender-adjusted mortality in the Leicestershire region.
In all, 1272 Barrett's patients were identified with 245 deaths in this cohort. Overall mortality was found to be increased [male standardized mortality ratio (SMR) = 552, 95% CI = 466-638; female SMR 455, 95% CI = 357-552]. The main disease areas that were responsible for this increase were oesophageal adenocarcinoma (n = 25, male SMR = 2171, 95% CI = 991-3351; female SMR = 1300, 95% CI = 26-2574), bronchopneumonia (n = 70, male SMR = 146, 95% CI = 55-236; female SMR = 436, 95% CI = 272-601) and ischaemic heart disease (n = 51, male SMR = 186, 95% CI = 97-2748; female SMR = 205, 95% CI = 105-306).
Patients with Barrett's oesophagus die more commonly of bronchopneumonia and ischaemic heart disease compared with oesophageal adenocarcinoma, and overall mortality in this group may be increased.
巴雷特食管患者发生食管腺癌的风险增加。观察性研究提示总体死亡率也有所上升，但数据存在矛盾。
评估巴雷特食管患者与普通人群相比的死亡原因。
利用英国莱斯特郡四家医院1997年至2003年的电子内镜检查和组织病理学记录，对巴雷特食管患者进行回顾性识别。通过国家统计局获取该队列患者的死亡数据，并与莱斯特郡地区经年龄和性别调整后的死亡率进行比较。
该队列共识别出1272例巴雷特食管患者，其中245例死亡。总体死亡率升高[男性标准化死亡比（SMR）=552，95%可信区间（CI）=466 - 638；女性SMR 455，95%CI = 357 - 552]。导致死亡率升高的主要疾病领域为食管腺癌（n = 25，男性SMR = 2171，95%CI = 991 - 3351；女性SMR = 1300，95%CI = 26 - 2574）、支气管肺炎（n = 70，男性SMR = 146，95%CI = 55 - 236；女性SMR = 436，95%CI = 272 - 601）和缺血性心脏病（n = 51，男性SMR = 186，95%CI = 97 - 2748；女性SMR = 205，95%CI = 105 - 306）。
与食管腺癌相比，巴雷特食管患者死于支气管肺炎和缺血性心脏病更为常见，且该组患者的总体死亡率可能升高。
