Katschinski B D, Logan R F, Davies J, Langman M J
Division of Gastroenterology, University Hospital Essen, FRG.
Postgrad Med J. 1989 Dec;65(770):913-7. doi: 10.1136/pgmj.65.770.913.
The outcome in 1017 patients with haematemesis and malaena referred to two major hospitals in Nottingham within a 2-year period has been prospectively evaluated. Ninety one (9%) patients died during the time period under consideration and all but four were found to have been over 60 years of age. There were 13 (14%) deaths following rebleeding, of whom 5 (5%) could have been potentially avoided by alterations in management. Some improvement of mortality might result from intensive-care facilities with better management of transfusions and earlier detection of rebleeding allowing earlier endoscopy or surgery. The majority of patients (81%), however, died from concomitant disease which was exacerbated by gastrointestinal haemorrhage or bleeding developed in patients with an already existing end-stage disease. These results show that a reduction of mortality in patients with gastrointestinal bleeding is hampered by the high number of poor-risk patients. The rise in the proportion of elderly patients with this disorder seems to continue.
对两年内转诊至诺丁汉两家主要医院的1017例呕血和黑便患者的治疗结果进行了前瞻性评估。在此期间，91例（9%）患者死亡，除4例之外，其余均为60岁以上。再出血后有13例（14%）死亡，其中5例（5%）通过改变治疗方式有可能避免。加强护理设施，更好地管理输血，更早发现再出血以便更早进行内镜检查或手术，可能会使死亡率有所改善。然而，大多数患者（81%）死于并发疾病，这些疾病因胃肠道出血而加重，或者在已有终末期疾病的患者中发生出血。这些结果表明，胃肠道出血患者死亡率的降低受到高危患者数量众多的阻碍。患有这种疾病的老年患者比例似乎还在继续上升。
