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叙利亚大马士革医院成年住院患者消化性溃疡出血的死亡率和相关因素:一项横断面研究。

Mortality and risk factors associated with peptic ulcer bleeding among adult inpatients of Damascus Hospital, Syria: A cross-sectional study.

机构信息

Gastroenterology Department of Damascus Hospital, Damascus, Syria.

出版信息

Medicine (Baltimore). 2023 Apr 25;102(17):e33699. doi: 10.1097/MD.0000000000033699.

Abstract

Peptic ulcer bleeding is associated with significant morbidity and mortality, while monitoring mortality is extremely beneficial to public health, and the latest estimates date back to 2010 for the Syrian population. This study aims to estimate the in-hospital mortality rate and risk factors associated with peptic ulcer bleeding among adult inpatients at Damascus Hospital, Syria. A cross-sectional study with systematic random sampling. Sample size (n) was calculated using the proportional equation: [n = Z2P (1 - P)/d2], with the following hypothesis: Z = 1.96 for the 95% confidence level, P = .253 for mortality in patients hospitalized with complicated peptic ulcers, a margin of error (d) = 0.05, 290 charts were reviewed, and the Chi-square test (χ2 test) was used for categorical variables, and the t test for continuous data. We reported the odds ratio in addition to mean and standard deviation with a 95% confidence. A P value less than .05 was considered statistically significant. Data were analyzed using a statistical package for the social sciences (SPSS). The mortality rate was 3.4%, and the mean age was 61.76 ± 16.02 years. The most frequent comorbidities were hypertension, diabetes mellitus, and ischemic heart disease. The most commonly used medications were NSAIDs, aspirin, and clopidogrel. 74 patients (25.52%) were using aspirin with no documented indication P < .01, odds ratio = 6.541, 95% CI [2.612-11.844]. There were 162 (56%) Smokers. Six patients (2.1%) suffered from recurrent bleeding, and 13 (4.5%) needed surgery. Raising awareness about the risks of using non-steroidal anti-inflammatory drugs may reduce the occurrence of peptic ulcers and, as a result, peptic ulcer complications. Larger, nationwide studies are needed to estimate the real mortality rate in complicated peptic ulcer patients in Syria. There is a lack of some critical data in the patients' charts, which necessitates action to correct.

摘要

消化性溃疡出血与较高的发病率和死亡率相关,而监测死亡率对公共卫生极为有益,且最新的估计数据可追溯到 2010 年的叙利亚人口。本研究旨在评估叙利亚大马士革医院成年住院患者消化性溃疡出血的住院死亡率和相关危险因素。这是一项采用系统随机抽样的横断面研究。使用比例方程计算样本量(n):[n = Z2P(1 - P)/d2],其中假设:Z = 1.96 为 95%置信水平,P =.253 为合并有复杂消化性溃疡的住院患者的死亡率,误差幅度(d)=.05,共回顾了 290 份图表,使用卡方检验(χ2 检验)进行分类变量分析,t 检验用于连续数据。我们报告了优势比以及平均值和标准差,置信区间为 95%。P 值小于.05 被认为具有统计学意义。使用社会科学统计软件包(SPSS)进行数据分析。死亡率为 3.4%,平均年龄为 61.76±16.02 岁。最常见的合并症是高血压、糖尿病和缺血性心脏病。最常用的药物是 NSAIDs、阿司匹林和氯吡格雷。74 名患者(25.52%)正在使用阿司匹林,但无记录表明有用药指征(P<.01),优势比=6.541,95%CI [2.612-11.844]。有 162 名患者(56%)为吸烟者。有 6 名患者(2.1%)发生再发性出血,13 名患者(4.5%)需要手术。提高对使用非甾体抗炎药风险的认识可能会减少消化性溃疡的发生,从而减少消化性溃疡并发症的发生。需要开展更大规模的全国性研究来估计叙利亚合并有复杂消化性溃疡患者的实际死亡率。患者图表中存在一些关键数据缺失,需要采取行动加以纠正。

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本文引用的文献

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Self-Medication Practices, Prevalence, and Associated Factors among Syrian Adult Patients: A Cross-Sectional Study.
J Environ Public Health. 2022 Jun 28;2022:9274610. doi: 10.1155/2022/9274610. eCollection 2022.
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Global Health. 2021 Sep 19;17(1):111. doi: 10.1186/s12992-021-00762-9.
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ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding.
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