Department of Gastroenterology, The 2nd Affiliated Hospital, Kunming Medical University, Kunming, Yunnan, China (mainland).
Institute of Digestive Diseases, Chinese PLA General Hospital, Beijing, China (mainland).
Med Sci Monit. 2018 Oct 6;24:7119-7129. doi: 10.12659/MSM.909560.
BACKGROUND This study aimed to discover the common cause of non-variceal upper-gastrointestinal bleeding (NVUGIB) by conducting a multi-center retrospective study from 2008 to 2012. MATERIAL AND METHODS Hospitalized patients ages ≥18 years old, from 8 hospitals in China, diagnosed with NVUGIB by endoscopy from 1 January 2008 to 31 December 2012 were enrolled. Questionnaires were developed and a data-entry graphical user interface was designed by using EpiData software. RESULTS Total of 2977 hospitalized patients from 8 medical centers were included. A total of 95.47% (2842/2977) of patients were admitted to a general ward, 3.53% (105/2977) were admitted to an emergency ward, and 1.00% (31/2977) were admitted to an intensive care unit. Peptic ulcer remained the most common cause of NVUGIB (73.26%), but there was a declining trend in its constituent ratio, from 2008 to 2012. A total of 14.41% (429/2977) of patients had co-morbid conditions, 92.85% (2764/2977) used proton-pump inhibitors (PPIs) prior to endoscopic treatment, 19.65% (585/2977) underwent emergency endoscopy, and 23.45% (698/2977) received a transfusion of red blood cell suspensions. A total of 5.34% (159/2977) underwent endoscopic therapy, with a treatment rate of 16.9% in high-risk peptic ulcer patients (96/568). A total of 7.69% (237/2977) were administered aspirin, of whom 32.50% (77/237) resumed aspirin intake after gastrointestinal bleeding was controlled. The median length of hospitalization was 8 days (IQR, 5-11) and the mortality rate was 1.71% (51/2977). CONCLUSIONS Peptic ulcer was still the most common cause of NVUGIB in China. The proportion of patients with high-risk peptic ulcer bleeding who received endoscopic therapy was 16.9%. Only 19.65% of NVUGIB patients underwent emergency endoscopy.
本研究通过对 2008 年至 2012 年期间 8 家医院的多中心回顾性研究,旨在发现非静脉曲张性上消化道出血(NVUGIB)的常见病因。
纳入年龄≥18 岁、经内镜诊断为 NVUGIB 并于 2008 年 1 月 1 日至 2012 年 12 月 31 日期间在 8 家中国医院住院的患者。采用 EpiData 软件设计问卷并开发数据录入图形用户界面。
共纳入 8 家中心的 2977 例住院患者。95.47%(2842/2977)的患者入住普通病房,3.53%(105/2977)入住急诊病房,1.00%(31/2977)入住重症监护病房。消化性溃疡仍然是 NVUGIB 的最常见病因(73.26%),但其构成比呈下降趋势,从 2008 年至 2012 年。共有 14.41%(429/2977)的患者合并有其他疾病,92.85%(2764/2977)在进行内镜治疗前使用质子泵抑制剂(PPIs),19.65%(585/2977)接受急诊内镜检查,23.45%(698/2977)输注红细胞悬液。共 5.34%(159/2977)接受了内镜治疗,高危消化性溃疡患者的治疗率为 16.9%(96/568)。共有 7.69%(237/2977)服用阿司匹林,其中 32.50%(77/237)在胃肠道出血得到控制后恢复服用阿司匹林。中位住院时间为 8 天(IQR,5-11),死亡率为 1.71%(51/2977)。
消化性溃疡仍然是中国 NVUGIB 的最常见病因。接受内镜治疗的高危消化性溃疡出血患者比例为 16.9%。仅 19.65%的 NVUGIB 患者接受了急诊内镜检查。