Chiu Philip W Y, Ng Enders K W
Department of Surgery, Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China.
Gastroenterol Clin North Am. 2009 Jun;38(2):215-30. doi: 10.1016/j.gtc.2009.03.009.
In conclusion, numerous prediction models identified pre-endoscopic and endoscopic risk factors for adverse clinical outcomes in patients with acute upper GI hemorrhage. The risk factors for mortality are different from those of rebleeding. Predictors for rebleeding are usually related to the severity of the bleeding and characteristics of the ulcer, whereas advanced age, physical status of the patient, and comorbidities are important predictors for mortality in addition to those for rebleeding. Future studies should focus on validation of these predictors in a prospective cohort and application of these prediction models to guide clinical management in patients with acute upper GI hemorrhage.
总之,众多预测模型确定了急性上消化道出血患者内镜检查前和内镜检查时不良临床结局的危险因素。死亡的危险因素与再出血的危险因素不同。再出血的预测因素通常与出血的严重程度和溃疡的特征有关,而高龄、患者的身体状况和合并症除了是再出血的重要预测因素外,也是死亡的重要预测因素。未来的研究应集中在前瞻性队列中对这些预测因素进行验证,并应用这些预测模型来指导急性上消化道出血患者的临床管理。