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巴西一家三级转诊医院中因消化性疾病导致非静脉曲张性上消化道出血患者的流行病学特征。

EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH NON-VARICEAL UPPER GASTROINTESTINAL BLEEDING SECONDARY TO PEPTIC DISEASE IN A TERTIARY REFERRAL BRAZILIAN HOSPITAL.

机构信息

Universidade Estadual Paulista (UNESP), Faculdade de Ciências Farmacêuticas, Departamento de Fármacos e Medicamentos, Araraquara, SP, Brasil.

Faculdade de Medicina da Universidade de São Paulo, Departamento de Cirurgia, Ribeirão Preto, SP, Brasil.

出版信息

Arq Gastroenterol. 2021 Apr-Jun;58(2):202-209. doi: 10.1590/S0004-2803.202100000-36.

Abstract

BACKGROUND

Non-variceal upper gastrointestinal bleeding (NVUGIB) secondary to peptic ulcer disease is a medical digestive emergency and could be one of the most serious adverse drug reactions.

OBJECTIVE

To identify the frequency of diagnosis of NVUGIB secondary to peptic ulcer disease.

METHODS

Prospective and epidemiological study conducted in a tertiary referral Brazilian hospital, from July 2016 to December 2019. Upper gastrointestinal endoscopies (UGE) reports were evaluated daily. The diagnosis of NVUGIB secondary to peptic ulcer disease was defined through endoscopic findings of peptic ulcer and erosive gastric lesions, and clinical symptoms. The frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was estimated through the ratio between the number of patients diagnosed and the number of patients underwent UGE in the same period.

RESULTS

A total of 2,779 endoscopic reports (2,503 patients) were evaluated, and 178 patients were eligible. The total frequency of diagnosis of NVUGIB secondary to peptic ulcer disease was 7.1%. The annual frequency of diagnosis between 2017 and 2019 ranged from 9.3% to 5.7%. Most patients were men (72.8%); self-declared white (71.8%); older people (56.7%); and, had no familiar or personal history of gastrointestinal diseases (60.1%). 90% of the patients had a peptic ulcer and melena (62.8%). Patients made chronic use of low-dose aspirin (29.3%), other antiplatelet agents (21.9%) and, oral anticoagulants (11.2%); and non-steroidal anti-inflammatories use in the week a prior to the onset of clinical symptoms (25.8%).

CONCLUSION

Seven in every 100 patients admitted and underwent UGE in a tertiary hospital were diagnosed with NVUGIB secondary to peptic ulcer disease.

摘要

背景

非静脉曲张性上消化道出血(NVUGIB)继发于消化性溃疡是一种医学消化系统急症,也是最严重的药物不良反应之一。

目的

确定消化性溃疡继发 NVUGIB 的诊断频率。

方法

这是一项在巴西三级转诊医院进行的前瞻性和流行病学研究,研究时间为 2016 年 7 月至 2019 年 12 月。每日评估上消化道内镜(UGE)报告。通过内镜下发现消化性溃疡和侵蚀性胃病变以及临床症状来诊断消化性溃疡继发 NVUGIB。通过同期接受 UGE 的患者中诊断为消化性溃疡继发 NVUGIB 的患者数量与同期接受 UGE 的患者数量的比值来估计消化性溃疡继发 NVUGIB 的诊断频率。

结果

共评估了 2779 份内镜报告(2503 名患者),其中 178 名患者符合条件。消化性溃疡继发 NVUGIB 的总诊断频率为 7.1%。2017 年至 2019 年的年诊断频率范围为 9.3%至 5.7%。大多数患者为男性(72.8%);自认为是白人(71.8%);年龄较大(56.7%);并且没有胃肠道疾病的家族或个人病史(60.1%)。90%的患者有消化性溃疡和黑便(62.8%)。患者长期使用小剂量阿司匹林(29.3%)、其他抗血小板药物(21.9%)和口服抗凝剂(11.2%);并且在出现临床症状前一周内使用非甾体抗炎药(25.8%)。

结论

在一家三级医院住院并接受 UGE 的患者中,每 100 人中有 7 人被诊断为消化性溃疡继发 NVUGIB。

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