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糖尿病对出血性消化性溃疡患者短期预后的影响。

The influence of diabetes mellitus on short-term outcomes of patients with bleeding peptic ulcers.

机构信息

Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.

出版信息

Yonsei Med J. 2012 Jul 1;53(4):701-7. doi: 10.3349/ymj.2012.53.4.701.

Abstract

PURPOSE

Little information is available on the influence of diabetes mellitus on the short-term clinical outcomes of patients with bleeding peptic ulcers. The aim of this study is to investigate whether diabetes mellitus influences the short-term clinical outcomes of patients with bleeding peptic ulcers using a Japanese national administrative database.

MATERIALS AND METHODS

A total of 4863 patients treated by endoscopic hemostasis on admission for bleeding peptic ulcers were referred to 586 participating hospitals in Japan. We collected their data to compare the risk-adjusted length of stay (LOS) and in-hospital mortality of patients with and without diabetes mellitus within 30 days. Patients were divided into two groups: patients with diabetes mellitus (n=434) and patients without diabetes mellitus (n=4429).

RESULTS

Mean LOS in patients with diabetes mellitus was significantly longer than those without diabetes mellitus (15.8 days vs. 12.5 days, p<0.001). Also, higher in-hospital mortality within 30 days was observed in patients with diabetes mellitus compared with those without diabetes mellitus (2.7% vs. 1.1%, p=0.004). Multiple linear regression analysis revealed that diabetes mellitus was significantly associated with an increase in risk-adjusted LOS. The standardized coefficient was 0.036 days (p=0.01). Furthermore, the analysis revealed that diabetes mellitus significantly increased the risk of in-hospital mortality within 30 days (odds ratio=2.285, 95% CI=1.161-4.497, p=0.017).

CONCLUSION

This study demonstrated that presence of diabetes mellitus significantly influences the short-term clinical outcomes of patients with bleeding peptic ulcers.

摘要

目的

关于糖尿病对出血性消化性溃疡患者短期临床结局的影响,相关信息较少。本研究旨在通过日本国家行政数据库,调查糖尿病是否会影响出血性消化性溃疡患者的短期临床结局。

材料和方法

共有 4863 例因出血性消化性溃疡入院接受内镜止血治疗的患者被转诊至日本的 586 家参与医院。我们收集了他们的数据,以比较 30 天内有和无糖尿病患者的风险调整后住院时间(LOS)和院内死亡率。患者分为两组:糖尿病患者(n=434)和无糖尿病患者(n=4429)。

结果

糖尿病患者的平均 LOS 明显长于无糖尿病患者(15.8 天比 12.5 天,p<0.001)。此外,糖尿病患者的 30 天内院内死亡率也高于无糖尿病患者(2.7%比 1.1%,p=0.004)。多线性回归分析显示,糖尿病与风险调整后 LOS 增加显著相关。标准化系数为 0.036 天(p=0.01)。此外,分析表明,糖尿病显著增加了 30 天内院内死亡的风险(比值比=2.285,95%CI=1.161-4.497,p=0.017)。

结论

本研究表明,糖尿病的存在显著影响出血性消化性溃疡患者的短期临床结局。

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