Ali Hassam, Bolick Nicole Leigh, Pamarthy Rahul, Farooq Muhammad Fahd, Farooq Muhammad Hassan, Eslam Ali
Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, North Carolina.
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida.
Proc (Bayl Univ Med Cent). 2022 Mar 15;35(3):291-296. doi: 10.1080/08998280.2022.2043806. eCollection 2022.
Dieulafoy's lesions are arguably underidentified rather than an infrequent cause of gastrointestinal bleeding. No population-based study exists regarding its inpatient outcomes in the United States. We evaluated the characteristics and inpatient outcomes for Dieulafoy's lesions using the National Inpatient Sample from 2016 to 2019. We identified 30,015 weighted hospitalizations for Dieulafoy's lesions. An initial diagnosis of Dieulafoy's lesions was established for 53.85% of patients on admission. The mean age was 68.7 ± 0.04 years, with male (56%) and white race predominance (70%). The mean length of stay and hospital cost were 7.87 days and $111,914, respectively. Significant predictors of inpatient mortality included heart failure, cardiac arrhythmias, coagulopathy, protein-calorie malnutrition, and alcoholism ( < 0.001). During inpatient hospitalization, 78% of patients underwent endoscopies, and 11% had colonoscopies. Inpatient mortality was 4.65%. Common comorbidities in Dieulafoy's lesions patients included heart failure (34%), cardiac arrhythmias (41%), hypertension (32%), chronic obstructive pulmonary disorders (25%), coagulopathic disorders (22%), and alcohol abuse (12%). Dieulafoy's lesions have a significant effect on length of stay and hospital cost. Endoscopies were used substantially more than colonoscopies for Dieulafoy's lesions, indicating a predominant presentation as upper gastrointestinal bleed. Cardiac disorders increase mortality in patients with Dieulafoy's lesions.
迪厄拉富瓦病(Dieulafoy's lesions)可说是未得到充分识别,而并非是导致胃肠道出血的罕见原因。在美国,尚无关于其住院治疗结局的基于人群的研究。我们使用2016年至2019年的全国住院患者样本评估了迪厄拉富瓦病的特征和住院治疗结局。我们识别出30,015例加权的迪厄拉富瓦病住院病例。53.85%的患者在入院时被初步诊断为迪厄拉富瓦病。平均年龄为68.7±0.04岁,以男性(56%)和白人种族为主(70%)。平均住院时间和住院费用分别为7.87天和111,914美元。住院死亡率的显著预测因素包括心力衰竭、心律失常、凝血病、蛋白质-热量营养不良和酗酒(P<0.001)。在住院期间,78%的患者接受了内镜检查,11%的患者接受了结肠镜检查。住院死亡率为4.65%。迪厄拉富瓦病患者常见的合并症包括心力衰竭(34%)、心律失常(41%)、高血压(32%)、慢性阻塞性肺疾病(25%)、凝血病(22%)和酒精滥用(12%)。迪厄拉富瓦病对住院时间和住院费用有显著影响。对于迪厄拉富瓦病,内镜检查的使用比结肠镜检查多得多,表明主要表现为上消化道出血。心脏疾病会增加迪厄拉富瓦病患者的死亡率。