Swansea University, UK.
Aliment Pharmacol Ther. 2011 Jan;33(1):64-76. doi: 10.1111/j.1365-2036.2010.04495.x.
Upper gastrointestinal (GI) bleeding is the most common emergency managed by gastroenterologists.
To establish the hospitalized incidence and case fatality for upper GI bleeding, and to determine how they are associated with factors including day of admission, hospital size, social deprivation and distance from hospital.
Systematic record linkage of hospital in-patient and mortality data for 24 421 admissions for upper GI bleeding among 22 299 people in Wales from 1999 to 2007.
The hospitalized incidence of upper GI bleeding was 134 per 100 000. Case fatality was 10.0%. Incidence was stable from 1999 to 2007; case fatality fell from 11.4% in 1999-2000 to 8.6% in 2006-7. Incidence was associated significantly with social deprivation. Compared with weekday admissions, case fatality was 13% higher for weekend admissions and 41% higher for admissions on public holidays. There was little variation in case fatality according to social deprivation, hospital size or distance from hospital.
Incidence, but not case fatality, was associated significantly with social deprivation. The higher mortality for weekend and public holiday admissions could not be explained by measures of case mix and may indicate a possible impact of reduced staffing levels and delays to endoscopy at weekends in some hospitals.
上消化道(GI)出血是胃肠病学家最常处理的急症。
确定上消化道出血的住院发病率和病死率,并确定它们与包括入院日、医院规模、社会贫困和与医院的距离等因素的关系。
对威尔士 1999 年至 2007 年间 22299 例上消化道出血住院患者中的 24421 例患者的住院和死亡记录进行系统记录链接。
上消化道出血的住院发病率为 134/100000。病死率为 10.0%。发病率从 1999 年到 2007 年保持稳定;病死率从 1999-2000 年的 11.4%降至 2006-7 年的 8.6%。发病率与社会贫困显著相关。与工作日入院相比,周末入院的病死率高 13%,公共假日入院的病死率高 41%。病死率与社会贫困、医院规模或与医院的距离无关。
发病率,但不是病死率,与社会贫困显著相关。周末和公共假日入院的死亡率较高不能用病例组合的措施来解释,这可能表明在某些医院周末工作人员减少和内镜检查延迟可能会产生影响。