尼日利亚一家三级医院急诊科上消化道出血患者的临床特征与转归

CLINICAL CHARACTERISTICS AND OUTCOME OF PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING AT THE EMERGENCY DEPARTMENT OF A TERTIARY HOSPITAL IN NIGERIA.

作者信息

Rukewe A, Otegbayo J A, Fatiregun A

机构信息

Department of Anaesthesia, University College Hospital, Ibadan, Nigeria.; Dept. of Anaesthesia & Critical Care, University of Botswana, Gaborone, Botswana.

Dept of Medicine, College of Medicine, University of Ibadan &University College Hospital, Ibadan, Nigeria.

出版信息

Ann Ib Postgrad Med. 2015 Dec;13(2):89-93.

PMID:27162520

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4853881/

Abstract

BACKGROUND

Upper gastrointestinal bleeding is a potentially life threatening condition with multiple causes. There is scarcity of health data depicting the clinical characteristics of the condition in African countries. This study was designed to describe the demographic, clinical characteristics and outcome of the patients who presented to our Emergency Department.

METHOD

The records of cohort of all patients admitted with upper gastrointestinal tract bleeding from 1 January 2011 to 31 December 2012 were retrospectively reviewed from admission to discharge or death.

RESULTS

There were 169 patients with median age of 44.0 years (range 13-89); 25 (15.0%) of them were known peptic ulcer disease patients. Most (69.2%) of the patients were males. The most common presenting symptom was haematemesis (34.9%) followed by melaena (16.6%). There was a history of NSAIDs use in 16.8% and alcohol ingestion in 12%. Upper Gastrointestinal Endoscopy was performed in 6.8% cases. Twenty-three (13.6%) patients died. There was association between mortality and diastolic blood pressure; more deaths (1/7; 14.3%) occurred in those with diastolic blood pressure > 90mmHg compared with ≤90mmHg (5/70; 7.1%) (P = 0.002). There were more deaths among patients who did not receive blood transfusion (4/40; 10.0%) compared with those who had blood transfusion (2/37; 5.4%) (P=0.008).

CONCLUSION

The common presentations were haematemesis and melaena, mainly in middle aged men with mortality in one out of seven patients. The high mortality may be due to co-morbidities and poor support services.

摘要

背景

上消化道出血是一种可能危及生命的疾病，病因多样。在非洲国家，缺乏描述该疾病临床特征的健康数据。本研究旨在描述就诊于我院急诊科患者的人口统计学、临床特征及预后情况。

方法

回顾性分析2011年1月1日至2012年12月31日期间所有因上消化道出血入院患者的病历，从入院至出院或死亡。

结果

共169例患者，中位年龄44.0岁（范围13 - 89岁）；其中25例（15.0%）为已知的消化性溃疡病患者。大多数患者（69.2%）为男性。最常见的症状是呕血（34.9%），其次是黑便（16.6%）。16.8%的患者有非甾体抗炎药使用史，12%的患者有饮酒史。6.8%的病例进行了上消化道内镜检查。23例（13.6%）患者死亡。死亡率与舒张压之间存在关联；舒张压>90mmHg的患者死亡率更高（1/7；14.3%），而舒张压≤90mmHg的患者死亡率为（5/70；7.1%）（P = 0.002）。未接受输血的患者死亡率更高（4/40；10.0%），而接受输血的患者死亡率为（2/37；5.4%）（P = 0.008）。