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美国憩室出血的季节性变化及其影响因素。

Seasonal Variations and Factors that Influence Diverticular Bleeding in the United States of America.

机构信息

Temple University, Lewis Katz School of Medicine, Philadelphia, PA, USA.

Temple University Hospital, Department of Surgery, Philadelphia, PA, USA.

出版信息

J Res Health Sci. 2023 Jun;23(2):e00577. doi: 10.34172/jrhs.2023.112.

Abstract

BACKGROUND

Seasonal variation in hospitalizations for diverticulitis has a sinusoidal pattern, peaking in summer. Little is known about seasonal, regional trends, and risk factors associated with hospital admissions regarding diverticular bleeding in the United States.

STUDY DESIGN

Cross-sectional population database review using the healthcare cost and utilization project's national inpatient sample.

METHODS

Patients that had diagnoses of diverticulitis with bleeding or diverticulosis with bleeding admitted from January 1, 2015, through December 31, 2017, were identified and stratified by month and season. Then, the potential effects of region, age, gender, race, and patient risk factors on seasonal admissions for diverticular bleeding were explored, and data were analyzed in SAS and presented in Excel using chi-square and Kruskal-Wallis for categorical and continuous variables, respectively.

RESULTS

Of the 54191 hospitalized cases for diverticular bleeding, the peak and the lowest seasons were spring and summer (25.5% vs. 24.2%, <0.0001). A significant seasonal pattern in comorbidities was also identified, and those with diabetes (<0.0001), hypertension (HTN) (<0.0001), obesity (<0.0001), and those on anticoagulants (=0.016) all had more bleeding events in the spring. This was noted across US regions, gender, race, and age. Eventually, the southern region had the most admissions for diverticular bleeding at 40.9% (<0.0001).

CONCLUSION

A better understanding of these seasonal and regional trends may provide a mechanism to identify a potential trigger for diverticular bleeding events. This helps identify individuals at greatest risk for hospitalization, as well as prepare hospitals to allocate supplies appropriately during the seasons.

摘要

背景

憩室炎住院的季节性变化呈正弦模式,夏季达到高峰。在美国,关于憩室出血的住院季节性、区域性趋势和相关风险因素知之甚少。

研究设计

使用医疗保健成本和利用项目的全国住院患者样本进行横断面人群数据库回顾。

方法

确定 2015 年 1 月 1 日至 2017 年 12 月 31 日期间因出血性憩室炎或出血性憩室病入院的患者,并按月份和季节分层。然后,探讨了区域、年龄、性别、种族和患者风险因素对憩室出血季节性入院的潜在影响,并在 SAS 中分析数据,并在 Excel 中使用卡方和 Kruskal-Wallis 分别对分类和连续变量进行呈现。

结果

在 54191 例因憩室出血住院的病例中,高峰期和最低季节为春季和夏季(25.5%比 24.2%,<0.0001)。还发现合并症存在明显的季节性模式,患有糖尿病(<0.0001)、高血压(HTN)(<0.0001)、肥胖(<0.0001)和服用抗凝剂的患者(=0.016)春季出血事件更多。这在全美各个地区、性别、种族和年龄中都有体现。最终,南部地区因憩室出血而住院的人数最多,占 40.9%(<0.0001)。

结论

更好地了解这些季节性和区域性趋势可能为识别憩室出血事件的潜在诱因提供一种机制。这有助于确定住院风险最大的个体,并为医院在季节期间适当分配物资做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/808f/10422131/dce417bced50/jrhs-23-e00577-g001.jpg

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