终末期肾病患者与非终末期肾病患者住院期间出血性消化性溃疡的比较分析
A Comparative Analysis of Bleeding Peptic Ulcers in Hospitalizations With and Without End-Stage Renal Disease.
作者信息
Dahiya Dushyant Singh, Mandoorah Sohaib, Gangwani Manesh Kumar, Ali Hassam, Merza Nooraldin, Aziz Muhammad, Singh Amandeep, Perisetti Abhilash, Garg Rajat, Cheng Chin-I, Dutta Priyata, Inamdar Sumant, Sanaka Madhusudhan R, Al-Haddad Mohammad
机构信息
Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI, USA.
These authors contributed equally to this article.
出版信息
Gastroenterology Res. 2023 Feb;16(1):17-24. doi: 10.14740/gr1605. Epub 2023 Feb 28.
BACKGROUND
End-stage renal disease (ESRD) patients are highly susceptible to peptic ulcer bleeding (PUB). We aimed to assess the influence of ESRD status on PUB hospitalizations in the United States (USA).
METHODS
We analyzed the National Inpatient Sample to identify all adult PUB hospitalizations in the USA from 2007 to 2014, which were divided into two subgroups based on the presence or absence of ESRD. Hospitalization characteristics and clinical outcomes were compared. Furthermore, predictors of inpatient mortality for PUB hospitalizations with ESRD were identified.
RESULTS
Between 2007 and 2014, there were 351,965 PUB hospitalizations with ESRD compared to 2,037,037 non-ESRD PUB hospitalizations. PUB ESRD hospitalizations had a higher mean age (71.6 vs. 63.6 years, P < 0.001), and proportion of ethnic minorities i.e., Blacks, Hispanics, and Asians compared to the non-ESRD cohort. We also noted higher all-cause inpatient mortality (5.4% vs. 2.6%, P < 0.001), rates of esophagogastroduodenoscopy (EGD) (20.7% vs. 19.1%, P < 0.001), and mean length of stay (LOS) (8.2 vs. 6 days, P < 0.001) for PUB ESRD hospitalizations compared to the non-ESRD cohort. After multivariate logistic regression analysis, Whites with ESRD had higher odds of mortality from PUB compared to Blacks. Furthermore, the odds of inpatient mortality from PUB decreased by 0.6% for every 1-year increase in age for hospitalizations with ESRD. Compared to the 2011 - 2014 study period, the 2007 - 2010 period had 43.7% higher odds (odds ratio (OR): 0.696, 95% confidence interval (CI): 0.645 - 0.751) of inpatient mortality for PUB hospitalizations with ESRD.
CONCLUSIONS
PUB hospitalizations with ESRD had higher inpatient mortality, EGD utilization, and mean LOS compared to non-ESRD PUB hospitalizations.
背景
终末期肾病（ESRD）患者极易发生消化性溃疡出血（PUB）。我们旨在评估ESRD状态对美国PUB住院治疗的影响。
方法
我们分析了全国住院患者样本，以确定2007年至2014年期间美国所有成年PUB住院病例，并根据是否存在ESRD将其分为两个亚组。比较了住院特征和临床结局。此外，还确定了ESRD的PUB住院患者的住院死亡率预测因素。
结果
2007年至2014年期间，有351,965例ESRD的PUB住院病例，而无ESRD的PUB住院病例为2,037,037例。与非ESRD队列相比，ESRD的PUB住院患者的平均年龄更高（71.6岁对63.6岁，P<0.001），少数民族（即黑人、西班牙裔和亚洲人）的比例更高。我们还注意到，与非ESRD队列相比，ESRD的PUB住院患者的全因住院死亡率更高（5.4%对2.6%，P<0.001），食管胃十二指肠镜检查（EGD）率更高（20.7%对19.1%，P<0.001），平均住院时间（LOS）更长（8.2天对6天，P<0.001）。多因素逻辑回归分析后，与黑人相比，患有ESRD的白人因PUB死亡的几率更高。此外，对于患有ESRD的住院患者，年龄每增加1岁，因PUB住院死亡的几率降低0.6%。与2011 - 2014年研究期相比，2007 - 2010年期间，ESRD的PUB住院患者的住院死亡率几率高43.7%（优势比（OR）：0.696，95%置信区间（CI）：0.645 - 0.751）。
结论
与非ESRD的PUB住院患者相比，ESRD的PUB住院患者的住院死亡率、EGD利用率和平均住院时间更高。
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