Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA, 19140, USA.
Department of Medicine, Reading Hospital -Tower Health, 420 S. Fifth Avenue, Reading, PA, 19606, USA.
Int J Colorectal Dis. 2019 Dec;34(12):2059-2067. doi: 10.1007/s00384-019-03421-z. Epub 2019 Nov 9.
The incidence of acute vascular insufficiency of intestine (AVII) is on the rise in the USA and is associated with significant morbidity and mortality. Seasonal variations have been observed in the onset of several gastrointestinal diseases. It is thus far unknown whether the incidence, in-hospital mortality rates, and length of hospital stay (LOS) of AVII vary in different seasons.
The aims of this study were to study the seasonal variations in the (1) incidence, (2) in-hospital mortality, and (3) LOS of AVII in the USA.
We used the Nationwide Inpatient Sample to identify patients aged ≥ 18 years hospitalized from the years 2000-2014. We used the Edwards recognition with estimation of cyclic trend method to study the seasonal variation of AVII hospitalizations and z test to compare the seasonal incidences (peak-to-low ratio), mortalities, and LOS.
A total of 1,441,447 patients were hospitalized with AVII (0.3% of all hospitalizations). Patients with AVII were older (69.0 ± 0.1 vs 56.9 ± 0.1) and more commonly females (65.4% vs 35.5%) than patients without AVII (p < 0.001). The incidence of AVII increased through the summer to peak in September (peak/low ratio 1.028, 95% CI 1.024-1.033, p < 0.001). Patients with AVII hospitalized in winter had the highest mortality (17.3%, p < 0.001) and LOS (9.2 ± 0.7 days, p < 0.001).
The incidence of AVII in the USA peaks in late summer. The in-hospital mortality rates and LOS associated with AVII are the highest in winter. Physicians could be cognizant of the seasonal variations in the incidence, in-hospital mortality, and LOS of AVII.
美国急性肠道血管供血不足（AVII）的发病率呈上升趋势，与较高的发病率和死亡率相关。在许多胃肠道疾病的发病中已经观察到季节性变化。目前尚不清楚 AVII 的发病率、住院死亡率和住院时间（LOS）是否因季节而异。
本研究旨在探讨美国 AVII 的（1）发病率、（2）住院死亡率和（3） LOS 的季节性变化。
我们使用全国住院患者样本，确定了 2000-2014 年期间年龄≥18 岁的住院患者。我们使用爱德华兹识别法和循环趋势估计法研究 AVII 住院的季节性变化，并用 Z 检验比较季节性发病率（峰值与低值比）、死亡率和 LOS。
共有 1441447 例患者因 AVII 住院（占所有住院患者的 0.3%）。与非 AVII 患者相比，AVII 患者年龄更大（69.0±0.1 岁比 56.9±0.1 岁），且更常见女性（65.4%比 35.5%）（p<0.001）。AVII 的发病率在夏季逐渐升高，在 9 月达到高峰（峰值/低值比为 1.028，95%CI 为 1.024-1.033，p<0.001）。冬季住院的 AVII 患者死亡率最高（17.3%，p<0.001），LOS 最长（9.2±0.7 天，p<0.001）。
美国 AVII 的发病率在夏末达到高峰。与 AVII 相关的住院死亡率和 LOS 最高在冬季。医生应该注意 AVII 的发病率、住院死亡率和 LOS 的季节性变化。
