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2014-2019 年英格兰与出血相关的住院治疗和死亡率。

Bleeding related hospitalizations and mortality in England 2014-2019.

机构信息

Department of Haematological Medicine, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, SE17EH, UK.

Department of Haematology, Sir Charles Gairdner Hospital, Perth, Australia.

出版信息

J Thromb Thrombolysis. 2023 Aug;56(2):233-240. doi: 10.1007/s11239-023-02849-z. Epub 2023 Jun 20.

Abstract

Acute bleeding is common and associated with increased morbidity and mortality. Epidemiological studies evaluating trends in bleeding-related hospitalisations and mortality are important as they have potential to guide resource allocation and service provision, however, despite this literature evaluating the national burden and annual trends are lacking. Our objective was to report the national burden and incidence of bleeding-related hospitalisation and mortality.This was a population-based review of all people in England between 2014 and 2019 either admitted to an acute care ward of a National Health Service (NHS) English hospital, or who died. Admissions and deaths were required to have a primary diagnosis of significant bleeding.There was a total of 3,238,427 hospitalisations with a mean of 539,738 ± 6033 per year and 81,264 deaths with a mean of 13,544 ± 331 per year attributable to bleeding. The mean annual incident rate for bleeding-related hospitalisations was 975 per 100,000 patient years and for mortality was 24.45. Over the study period there was a significant 8.2% reduction in bleeding related deaths (χ test for trend 91.4, p < 0.001). A direct relationship between increasing age and incidence of bleeding-related hospitalisation and mortality was seen.Bleeding remains a common cause of hospitalisation and death. The reduction in bleeding related mortality requires further investigation. This data may serve to guide future interventions designed to reduce bleeding-related morbidity and mortality.

摘要

急性出血很常见,与发病率和死亡率增加有关。评估与出血相关的住院和死亡率趋势的流行病学研究很重要,因为它们有可能指导资源分配和服务提供,然而,尽管有评估国家负担和年度趋势的文献,但仍然缺乏。我们的目的是报告与出血相关的住院和死亡率的国家负担和发生率。这是一项基于人群的研究,对 2014 年至 2019 年期间英格兰的所有人群进行了研究,这些人群要么入住了英国国民保健制度(NHS)英格兰医院的急性护理病房,要么死亡。住院和死亡需要有明显出血的主要诊断。共有 3238427 例住院,平均每年 539738±6033 例,81264 例死亡,平均每年 13544±331 例归因于出血。与出血相关的住院的年发生率平均为 975/100000 患者年,死亡率为 24.45。在研究期间,与出血相关的死亡人数减少了 8.2%(趋势检验 χ 2=91.4,p<0.001)。与出血相关的住院和死亡的发生率与年龄的增加呈直接关系。出血仍然是住院和死亡的常见原因。出血相关死亡率的降低需要进一步调查。这些数据可能有助于指导旨在降低出血相关发病率和死亡率的未来干预措施。

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