Hajiagha Mohammadi Ali Akbar, Reza Azizi Mohammad
Department of Internal Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Internal Medicine, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Arab J Gastroenterol. 2019 Mar;20(1):23-27. doi: 10.1016/j.ajg.2019.01.001. Epub 2019 Feb 12.
Acute upper gastrointestinal bleeding is one of the main causes of hospitalisation. The purpose of this study was to determine the prognostic factors in non-variceal upper gastrointestinal bleeding.
Clinical outcomes, demographic and laboratory variables of the subjects were collected from the HIS software and national code with the SQL format from three hospitals in Qazvin. The data were linked to the database software designed by the author. Clinical and upper endoscopic findings of patients' records were collected through a questionnaire form in the designed software database.
In this study, 29.2% of patients with favourable outcome and 64.2% of patients with unfavourable clinical outcomes had a history of anticoagulant drug use before hospitalisation (p < 0.001). The prevalence of chronic cardiovascular disease, chronic liver disease, chronic lung disease, diabetes and dialysis was higher in subjects with poor clinical outcomes than those with a favourable clinical outcome. 53.1% of subjects with favourable clinical outcome and 90.5% of subjects with undesirable clinical outcomes received packed red blood cell transfusion (p < 0.001). 16.1% of subjects with desirable clinical outcome and 86.3% of subjects with undesirable clinical outcomes received endoscopic haemostatic treatment which was statistically significant (p < 0.001).
Undesirable clinical outcome in patients with acute non-variceal upper gastrointestinal bleeding has a significant statistical association with longer hospitalisation, chronic underlying disease, anticoagulant administration, packed red blood cell infusion, higher Forrest stage, low systolic blood pressure, higher age, low haemoglobin, low platelet count, high INR and high BUN at the onset of diagnosis.
急性上消化道出血是住院的主要原因之一。本研究的目的是确定非静脉曲张性上消化道出血的预后因素。
从加兹温市三家医院的医院信息系统（HIS）软件和采用SQL格式的国家编码中收集受试者的临床结局、人口统计学和实验室变量。这些数据与作者设计的数据库软件相关联。通过设计软件数据库中的问卷形式收集患者记录的临床和上消化道内镜检查结果。
在本研究中，预后良好的患者中有29.2%以及临床结局不良的患者中有64.2%在住院前有抗凝药物使用史（p<0.001）。临床结局不良的受试者中慢性心血管疾病、慢性肝病、慢性肺病、糖尿病和透析的患病率高于临床结局良好的受试者。临床结局良好的受试者中有53.1%以及临床结局不良的受试者中有90.5%接受了红细胞悬液输注（p<0.001）。临床结局良好的受试者中有（此处原文可能有误，推测为16.1%）以及临床结局不良（此处原文可能有误，推测为86.3%）的受试者接受了内镜止血治疗，差异有统计学意义（p<0.001）。
急性非静脉曲张性上消化道出血患者的不良临床结局与住院时间延长、慢性基础疾病、抗凝药物使用、红细胞悬液输注、福里斯特分级较高、收缩压较低、年龄较大、血红蛋白水平较低、血小板计数较低、国际标准化比值（INR）较高以及诊断开始时血尿素氮（BUN）较高有显著统计学关联。
