aDepartment of Gastroenterology & Hepatology, Al Azhar Faculty of Medicine, Al Azhar Assiut University Hospital, Al Azhar University, Assiut, Egypt bDepartment of Virology, Division of Liver Diseases, Ichan School of Medicine at Mount Sinai, New York, New York, USA.
Eur J Gastroenterol Hepatol. 2014 Feb;26(2):187-91. doi: 10.1097/MEG.0b013e328365c3b0.
Patients with acute upper gastrointestinal (GI) bleeding commonly present with hematemesis and/or melena. More studies are needed to confirm the ability to predict mortality, length of stay, and cost. Alcohol abuse may worsen variceal bleeding or portal hypertensive gastropathy in a patient with a history of liver disease. Coexisting alcoholism may influence patient management in the setting of peptic ulceration or existing malignancy. Consequently, the overall morbidities and mortalities may differ in alcoholic and nonalcoholic groups accordingly. Mortality prediction using data mining programs is helpful for detection of significant mortality-related factors.
We retrospectively reviewed 152 files of patients presenting with upper GI bleeding, because of nonalcoholic causes, 100 males and 52 females aged 16-77 years old. Causes of upper GI bleeding were esophageal and/or gastric varices (51), portal hypertensive congestive gastropathy (6), gastric and/or duodenal ulcers (39), gastroesophageal reflux disease (20), gastritis and duodenitis (19), cancer (8), gastric polyps (3), blood diseases (2), Dieulafoy's lesion (2), and no aberrant cause of bleeding in two patients.
The overall mortality was 29 patients (19.07%). The use of a descriptive model of the data mining program yielded the most significant mortality predictors. The overall accuracy was 92.08%.
Chronic hepatitis C virus infection and NSAID-associated splenomegaly because of portal hypertension are significant predictors of mortality in nonalcoholic patients presenting with upper GI bleeding.
急性上消化道（GI）出血的患者常表现为呕血和/或黑便。需要更多的研究来证实其对死亡率、住院时间和成本的预测能力。酒精滥用可能会加重有肝病病史患者的静脉曲张出血或门静脉高压性胃病。并存的酒精中毒可能会影响消化性溃疡或现有恶性肿瘤患者的治疗管理。因此，相应地，酒精性和非酒精性患者的整体发病率和死亡率可能有所不同。使用数据挖掘程序进行死亡率预测有助于发现与死亡率相关的重要因素。
我们回顾性分析了 152 例非酒精性上消化道出血患者的病历，其中男性 100 例，女性 52 例，年龄 16-77 岁。上消化道出血的原因包括食管和/或胃静脉曲张（51 例）、门静脉高压性充血性胃病（6 例）、胃和/或十二指肠溃疡（39 例）、胃食管反流病（20 例）、胃炎和十二指肠炎（19 例）、癌症（8 例）、胃息肉（3 例）、血液疾病（2 例）、Dieulafoy 病变（2 例），另有 2 例患者无异常出血原因。
总体死亡率为 29 例（19.07%）。数据挖掘程序描述性模型的使用产生了最显著的死亡率预测因子。总体准确率为 92.08%。
慢性丙型肝炎病毒感染和非甾体抗炎药相关性脾肿大引起的门静脉高压是非酒精性上消化道出血患者死亡的重要预测因子。
