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新型冠状病毒肺炎大流行对胃肠道出血的流行病学趋势和结局的影响:一项全国性研究。

Effect of the COVID-19 pandemic on the epidemiological trends and outcomes of gastrointestinal bleeding: a nationwide study.

作者信息

Kwei-Nsoro Robert, Ojemolon Pius, Laswi Hisham, Ebhohon Ebehiwele, Ufeh Annabel Ogar, Nieto Alejandro, Mir Wasey Ali, Shaka Abdultawab, Shaka Hafeez

机构信息

Department of Internal Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois.

Department of Internal Medicine, Lincoln Medical Center, Bronx, New York.

出版信息

Proc (Bayl Univ Med Cent). 2023 Jan 9;36(2):145-150. doi: 10.1080/08998280.2023.2165319. eCollection 2023.

Abstract

The COVID-19 pandemic altered healthcare delivery in the United States. This study examined the effect of the COVID-19 pandemic on the epidemiological trends and outcomes of gastrointestinal bleeding. We compared the admission rate, in-hospital mortality rate, and mean length of hospital stay between 2019 and 2020 to estimate the pandemic effect. The study highlighted disparities in outcomes of gastrointestinal bleeding hospitalizations stratified by sex and race. We noted a 9.5% reduction in the total number of hospitalizations in 2020. We also observed a 13% increase in overall mortality during the pandemic ( < 0.001). There was a 15.8% increase in mortality among men ( 0.007), compared to a 4.7% increase among women ( 0.059). There was a significant increase in mortality among Whites in 2020 compared to Black and Hispanic populations. On multivariable logistic regression, admission during the COVID-19 pandemic was associated with increased length of stay when adjusted for age, sex, and race. Despite the direct COVID-19-related morbidity and mortality, the so-called indirect effect of the pandemic cannot be overlooked. For the remainder of the pandemic and future health emergencies, it is critical to balance mitigation of the spread of the contagion with clear public health messages to not neglect other life-threatening emergencies.

摘要

新冠疫情改变了美国的医疗服务提供方式。本研究调查了新冠疫情对胃肠道出血的流行病学趋势及治疗结果的影响。我们比较了2019年和2020年的住院率、院内死亡率及平均住院时长,以评估疫情的影响。该研究强调了按性别和种族分层的胃肠道出血住院治疗结果的差异。我们注意到2020年住院总数减少了9.5%。我们还观察到疫情期间总体死亡率上升了13%(<0.001)。男性死亡率上升了15.8%(P=0.007),而女性死亡率上升了4.7%(P=0.059)。与黑人和西班牙裔人群相比,2020年白人的死亡率显著上升。在多变量逻辑回归分析中,在对年龄、性别和种族进行校正后,新冠疫情期间住院与住院时长增加相关。尽管存在与新冠直接相关的发病率和死亡率,但疫情的所谓间接影响也不容忽视。对于疫情的剩余阶段以及未来的突发卫生事件,在通过明确的公共卫生信息减缓传染病传播的同时,平衡好不忽视其他危及生命的紧急情况至关重要。

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Trends in upper gastrointestinal bleeding during the COVID-19 pandemic.2019冠状病毒病大流行期间上消化道出血的趋势
Ann Gastroenterol. 2020 Sep-Oct;33(5):543-544. doi: 10.20524/aog.2020.0510. Epub 2020 Jun 30.

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