Ljubičić Neven, Budimir Ivan, Pavić Tajana, Bišćanin Alen, Puljiz Zeljko, Bratanić Andre, Troskot Branko, Zekanović Dražen
Department of Internal Medicine, Division of Gastroenterology, "Sestre milosrdnice" University Hospital Center, Medical and Dental Faculty, University of Zagreb , Zagreb 10000, Vinogradska 29 , Croatia.
Scand J Gastroenterol. 2014 Apr;49(4):458-64. doi: 10.3109/00365521.2013.846404. Epub 2014 Feb 5.
The aim of this study was to identify the predictive factors influencing mortality in patients with bleeding Mallory-Weiss syndrome in comparison with peptic ulcer bleeding.
Between January 2005 and December 2009, 281 patients with endoscopically confirmed Mallory-Weiss syndrome and 1530 patients with peptic ulcer bleeding were consecutively evaluated. The 30-day mortality and clinical outcome were related to the patients' demographic data, endoscopic, and clinical characteristics.
The one-year cumulative incidence for bleeding Mallory-Weiss syndrome was 7.3 cases/100,000 people and for peptic ulcer bleeding 40.4 cases/100,000 people. The age-standardized incidence for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding remained unchanged during the observational five-year period. The majority of patients with bleeding Mallory-Weiss syndrome were male patients with significant overall comorbidities (ASA class 3-4). Overall 30-day mortality rate was 5.3% for patients with bleeding Mallory-Weiss syndrome and 4.6% for patients with peptic ulcer bleeding (p = 0.578). In both patients with bleeding Mallory-Weiss syndrome and peptic ulcer bleeding, mortality was significantly higher in patients over 65 years of age and those with significant overall comorbidities (ASA class 3-4).
The incidence of bleeding Mallory-Weiss syndrome and peptic ulcer bleeding has not changed over a five-year observational period. The overall 30-day mortality was almost equal for both bleeding Mallory-Weiss syndrome and peptic ulcer bleeding and was positively correlated to older age and underlying comorbid illnesses.
本研究旨在确定与消化性溃疡出血相比，影响马洛里-魏斯综合征出血患者死亡率的预测因素。
2005年1月至2009年12月期间，对281例经内镜确诊的马洛里-魏斯综合征患者和1530例消化性溃疡出血患者进行了连续评估。30天死亡率和临床结局与患者的人口统计学数据、内镜检查及临床特征相关。
马洛里-魏斯综合征出血的一年累积发病率为7.3例/10万人，消化性溃疡出血为40.4例/10万人。在观察的五年期间，马洛里-魏斯综合征出血和消化性溃疡出血的年龄标准化发病率均保持不变。大多数马洛里-魏斯综合征出血患者为男性，总体合并症严重（美国麻醉医师协会3-4级）。马洛里-魏斯综合征出血患者的总体30天死亡率为5.3%，消化性溃疡出血患者为4.6%（p = 0.578）。在马洛里-魏斯综合征出血患者和消化性溃疡出血患者中，65岁以上患者及总体合并症严重（美国麻醉医师协会3-4级）的患者死亡率均显著更高。
在五年观察期内，马洛里-魏斯综合征出血和消化性溃疡出血的发病率未发生变化。马洛里-魏斯综合征出血和消化性溃疡出血的总体30天死亡率几乎相等，且与年龄较大及潜在合并症呈正相关。
