Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals, NHS Trust, UK.
Eur J Gastroenterol Hepatol. 2009 Aug;21(8):861-5. doi: 10.1097/MEG.0b013e328314b7f6.
Upper gastrointestinal haemorrhage (UGIH) is a common emergency, however, dedicated bleed units only exist in selected hospitals in the UK.
To evaluate the rebleeding and mortality rate of patients admitted with UGIH to a tertiary centre bleed unit in comparison with the current national standards and earlier unit performance in 1995-1998.
A retrospective case note review of demographics, the Rockall scores and final outcome was conducted for all patients admitted to the bleed unit over 24 months.
Two hundred and fifty-five cases were identified with a mean age of 62 years and a median Rockall score of 3. Eighty-two percent of gastroscopies were performed within 24 h. Of these, 29% were undertaken after 5 p.m. Peptic ulcer and varices (15%) were the commonest diagnosis. The rebleeding (12%) and mortality rate (9%) were comparable with that of the units previous audit (P=0.47, 0.51, respectively) and the current national audit (P=0.58, 0.76, respectively). The number of patients requiring surgery has reduced from 6 to 0.4% in our unit over the last 8 years. Preendoscopy and postendoscopy Rockall scores were predictive of rebleeding (P=0.013, 0.045) and mortality (P=0.003, 0.01).
This study has shown a consistently low rebleeding and mortality rate in patients with UGIH in a dedicated bleed unit. However there are limitations to the degree of improvements which can be demonstrated due to factors such as age and comorbidity.
上消化道出血（UGIH）是一种常见的急症，但在英国，只有选定的医院设有专门的出血病房。
评估在三级中心出血病房因 UGIH 住院的患者的再出血和死亡率，与当前的国家标准和 1995-1998 年早期病房表现进行比较。
对 24 个月内在出血病房住院的所有患者进行回顾性病历回顾，评估人口统计学、Rockall 评分和最终结果。
确定了 255 例患者，平均年龄为 62 岁，中位数 Rockall 评分为 3 分。82%的胃镜检查在 24 小时内进行。其中，29%的胃镜检查在下午 5 点后进行。消化性溃疡和静脉曲张（15%）是最常见的诊断。再出血率（12%）和死亡率（9%）与前一次病房审计（P=0.47、0.51）和当前国家审计（P=0.58、0.76）相似。在过去 8 年中，我们病房需要手术的患者数量从 6 例减少到 0.4%。内镜检查前和内镜检查后的 Rockall 评分是再出血（P=0.013、0.045）和死亡率（P=0.003、0.01）的预测因素。
这项研究表明，在专门的出血病房中，UGIH 患者的再出血和死亡率一直保持较低水平。然而，由于年龄和合并症等因素的限制，能够证明的改善程度有限。
