Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Japan.
Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Japan.
Intern Med. 2020 Aug 1;59(15):1789-1794. doi: 10.2169/internalmedicine.4308-19. Epub 2020 Apr 23.
Objective Carbazochrome sodium sulfonate (CSS) has been routinely used to treat bleeding; however, no study has examined the effect of CSS for gastrointestinal bleeding. Therefore, we aimed to investigate the effect of CSS for colonic diverticular bleeding. Methods We performed a nationwide observational study using the Japanese Diagnosis Procedure Combination inpatient database. We identified patients who were admitted for diverticular bleeding from July 2010 to March 2018. Patients who received CSS on the day of admission were defined as the CSS group, and those not receiving CSS were defined as the control group. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, total costs, and blood transfusion within 7 days of admission. Propensity score matching analyses were performed to compare outcomes between the two groups. Results A total of 59,965 patients met our eligibility criteria. Of these, 14,437 (24%) patients received CSS on the day of admission. One-to-one propensity score matching created 14,379 matched pairs. There was no significant difference in the in-hospital mortality between the CSS and control groups (0.6% vs. 0.5%, respectively; odds ratio: 0.96; 95% confidence interval: 0.72-1.29). The length of stay was longer in the CSS group than in the control group (11.4 vs. 11.0 days, respectively; difference: 0.44; 95% confidence interval: 0.14-0.73). There were no significant differences in the total costs or the proportion of patients receiving blood transfusion between the groups. Conclusions CSS may not reduce in-hospital mortality, length of stay, total costs, or the need for blood transfusion in patients with colonic diverticular bleeding.
目的 卡巴克络(CSS)已常规用于治疗出血;然而,尚无研究评估 CSS 治疗结肠憩室出血的效果。因此,我们旨在研究 CSS 治疗结肠憩室出血的效果。
方法 我们使用日本诊断程序组合住院数据库进行了一项全国性观察性研究。我们确定了 2010 年 7 月至 2018 年 3 月因憩室出血而入院的患者。入院当天接受 CSS 治疗的患者定义为 CSS 组,未接受 CSS 治疗的患者定义为对照组。主要结局为住院期间死亡率。次要结局为住院时间、总费用和入院后 7 天内输血。进行倾向评分匹配分析以比较两组的结局。
结果 共有 59965 名患者符合纳入标准。其中,24%(14437 名)患者在入院当天接受 CSS 治疗。通过 1:1 倾向评分匹配,创建了 14379 对匹配。CSS 组和对照组的住院期间死亡率无显著差异(分别为 0.6%和 0.5%;优势比:0.96;95%置信区间:0.72-1.29)。CSS 组的住院时间长于对照组(分别为 11.4 天和 11.0 天;差异:0.44;95%置信区间:0.14-0.73)。两组间总费用或输血患者比例无显著差异。
结论 CSS 治疗结肠憩室出血可能不会降低住院期间死亡率、住院时间、总费用或输血需求。