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一组埃及老年急性上消化道出血患者院内死亡的预测因素

Predictors of in-hospital mortality in a cohort of elderly Egyptian patients with acute upper gastrointestinal bleeding.

作者信息

Elsebaey Mohamed A, Elashry Heba, Elbedewy Tamer A, Elhadidy Ahmed A, Esheba Noha E, Ezat Sherif, Negm Manal Saad, Abo-Amer Yousry Esam-Eldin, Abgeegy Mohamed El, Elsergany Heba Fadl, Mansour Loai, Abd-Elsalam Sherief

机构信息

Internal Medicine Department Tropical Medicine Department, Tanta University Mahalla Hepatology Teaching Hospital, Elgharbia National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt.

出版信息

Medicine (Baltimore). 2018 Apr;97(16):e0403. doi: 10.1097/MD.0000000000010403.

Abstract

Acute upper gastrointestinal bleeding (UGIB) affects large number of elderly with high rates of morbidity and mortality. Early identification and management of the factors predicting in-hospital mortality might decrease mortality. This study was conducted to identify the causes of acute UGIB and the predictors of in-hospital mortality in elderly Egyptian patients.286 elderly patients with acute UGIB were divided into: bleeding variceal group (161 patients) and bleeding nonvariceal group (125 patients). Patients' monitoring was done during hospitalization to identify the risk factors that might predict in-hospital mortality in elderly.Variceal bleeding was the most common cause of acute UGIB in elderly Egyptian patients. In-hospital mortality rate was 8.74%. Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding were the predictors of in-hospital mortality.Increasing age, hemodynamic instability at presentation, co-morbidities (especially liver cirrhosis associated with other co-morbidity) and failure to control bleeding should be considered when triaging those patients for immediate resuscitation, close observation, and early treatment.

摘要

急性上消化道出血(UGIB)影响大量老年人,其发病率和死亡率很高。早期识别和处理预测住院死亡率的因素可能会降低死亡率。本研究旨在确定埃及老年患者急性UGIB的病因及住院死亡率的预测因素。286例急性UGIB老年患者被分为:静脉曲张出血组(161例患者)和非静脉曲张出血组(125例患者)。住院期间对患者进行监测,以确定可能预测老年患者住院死亡率的危险因素。静脉曲张出血是埃及老年患者急性UGIB最常见的病因。住院死亡率为8.74%。年龄增加、就诊时血流动力学不稳定、合并症(尤其是与其他合并症相关的肝硬化)以及出血未能得到控制是住院死亡率的预测因素。在对这些患者进行分诊以便立即复苏、密切观察和早期治疗时,应考虑年龄增加、就诊时血流动力学不稳定、合并症(尤其是与其他合并症相关的肝硬化)以及出血未能得到控制等因素。

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