Can J Gastroenterol Hepatol. 2014 Mar;28(3):135-9. doi: 10.1155/2014/291289.
Nonvariceal upper gastrointestinal bleeding (NVUGIB) is associated with significant mortality.
To examine several factors that may impact the mortality and 30-day rebleed rates of patients presenting with NVUGIB.
A retrospective study of the charts of patients admitted to hospital in either the Saskatoon Health Region (SHR) or Regina Qu'Appelle Health Region (RQHR) (Saskatchewan) in 2008 and 2009 was performed. Mortality and 30-day rebleed end points were stratified according to age, sex, day of admission, patient status, health region, specialty of the endoscopist and time to endoscopy. Logistic regression modelling was performed, controlling for the Charlson comorbidity index, age and sex as covariates.
The overall mortality rate observed was 12.2% (n=44), while the overall 30-day rebleed rate was 20.3% (n=80). Inpatient status at the time of the rebleeding event was associated with a significantly increased risk of both mortality and rebleed, while having endoscopy performed in the RQHR versus SHR was associated with a significantly decreased risk of rebleed. A larger proportion of endoscopies were performed both within 24 h and by a gastroenterologist in the RQHR.
Saskatchewan has relatively high rates of mortality and 30-day rebleeding among patients with NVUGIB compared with published rates. The improved outcomes observed in the RQHR, when compared with the SHR, may be related to the employ of a formal call-back endoscopy team for the treatment of NVUGIB.
非静脉曲张性上消化道出血（NVUGIB）与较高的死亡率相关。
研究可能影响 NVUGIB 患者死亡率和 30 天再出血率的多种因素。
对 2008 年和 2009 年萨斯喀彻温省萨斯卡通卫生区（SHR）和里贾纳夸佩尔卫生区（RQHR）住院患者的病历进行回顾性研究。根据年龄、性别、入院日、患者状态、卫生区、内镜医生专业和内镜检查时间分层死亡率和 30 天再出血终点。使用逻辑回归模型，控制 Charlson 合并症指数、年龄和性别作为协变量。
观察到的总体死亡率为 12.2%（n=44），总体 30 天再出血率为 20.3%（n=80）。再出血事件时的住院状态与死亡率和再出血风险显著增加相关，而在 RQHR 进行内镜检查与再出血风险显著降低相关。RQHR 中，在 24 小时内和由胃肠病学家进行的内镜检查比例均较高。
与已发表的比率相比，萨斯喀彻温省 NVUGIB 患者的死亡率和 30 天再出血率相对较高。与 SHR 相比，RQHR 观察到的结果改善可能与 NVUGIB 治疗采用正式的召回内镜团队有关。
