Hunt P S, Hansky J, Korman M G
Br Med J. 1979 May 12;1(6173):1238-40. doi: 10.1136/bmj.1.6173.1238.
In a prospective study of death in 817 patients with haematemesis and melaena admitted on 894 occasions, the protocol included admission of all patients to a defined unit, early endoscopy and resuscitation, and planned management. Over the three consecutive two-year periods of the study mortality significantly decreased from 9% to 2.4%. Although the operative rate remained the same, the operative mortality fell from 16% to 1.6%. The fall in mortality was greatest in patients with bleeding gastric ulcers. These results suggest that prospective studies with a defined policy can influence the mortality in patients with upper gastrointestinal bleeding.
在一项对894例因呕血和黑便入院的817例患者的前瞻性死亡研究中,方案包括将所有患者收入一个特定病房、早期内镜检查和复苏以及计划性管理。在该研究连续的三个两年期内,死亡率从9%显著降至2.4%。尽管手术率保持不变,但手术死亡率从16%降至1.6%。胃溃疡出血患者的死亡率下降幅度最大。这些结果表明,采用明确策略的前瞻性研究可影响上消化道出血患者的死亡率。