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初次发作后一年消化性溃疡出血的危险因素。

Risk factors for peptic ulcer bleeding one year after the initial episode.

作者信息

Peng Yu-Xuan, Chang Wen-Pei

机构信息

Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan.

Department of Nursing, Shuang Ho Hospital, Taipei Medical University, No. 291, Zhongzheng Rd, Zhonghe, New Taipei City, 23561, Taiwan.

出版信息

Gut Pathog. 2024 Nov 28;16(1):71. doi: 10.1186/s13099-024-00669-x.

Abstract

BACKGROUND

Peptic ulcers are a common gastrointestinal disease that could cause death when combined with bleeding. The aim of this study was to identify risk factors for peptic ulcer bleeding (PUB) recurrence after the initial episode.

METHODS

This retrospective study analyzed medical records of PUB patients who were admitted through the emergency department between January 1, 2020, and December 31, 2022. A multivariate logistic regression model was used to identify independent risk factors predicting readmission due to recurrent PUB within one year.

RESULTS

A total of 775 PUB inpatient samples were collected, among which 172 and 603 were placed respectively in the readmission group and non-readmission group. Multivariate analysis indicated that PUB inpatients who were aged 70 or above (OR = 1.62, 95% CI: 1.06-2.47), had more severe ulcers (Forrest 1a, 1b, 2a, or 2b) (OR = 2.41, 95% CI:1.57-3.71), had a CCI score of 3 or higher (OR = 2.25, 95% CI:1.45-3.50), had a medical history of peptic ulcers (OR = 3.87, 95% CI:2.56-5.85), had a medical history of cardiovascular disease (CVD) (OR = 2.31, 95% CI:1.53-3.50), or had an international normalized ratio (INR) > 1.2 on admission (OR = 2.14, 95% CI:1.28-3.57) were respectively more likely to be readmitted within a year due to PUB than those who were under the age of 70, had less severe ulcers (Forrest 2c or 3), had a CCI score of less than 3, had no medical history of peptic ulcers, had no medical history of CVD, or had admission INR ≤ 1.2.

CONCLUSION

This study confirmed that age (≥70 years), Forest classification (Forrest 1a, 1b, 2a, or 2b), multiple comorbidities, a medical history of peptic ulcers, a medical history of CVD, and admission INR > 1.2 were independent risk factors for patient readmission within a year due to recurrent PUB.

摘要

背景

消化性溃疡是一种常见的胃肠道疾病,合并出血时可能导致死亡。本研究的目的是确定初次发作后消化性溃疡出血(PUB)复发的危险因素。

方法

这项回顾性研究分析了2020年1月1日至2022年12月31日期间通过急诊科收治的PUB患者的病历。采用多因素logistic回归模型确定预测一年内因复发性PUB再次入院的独立危险因素。

结果

共收集了775例PUB住院患者样本,其中172例和603例分别纳入再入院组和非再入院组。多因素分析表明,年龄在70岁及以上(OR = 1.62,95%CI:1.06 - 2.47)、溃疡更严重(Forrest 1a、1b、2a或2b)(OR = 2.41,95%CI:1.57 - 3.71)、Charlson合并症指数(CCI)评分3分及以上(OR = 2.25,95%CI:1.45 - 3.50)、有消化性溃疡病史(OR = 3.87,95%CI:2.56 - 5.85)、有心血管疾病(CVD)病史(OR = 2.31,95%CI:1.53 - 3.50)或入院时国际标准化比值(INR)>1.2(OR = 2.14,95%CI:1.28 - 3.57)的PUB住院患者,与年龄小于70岁、溃疡较轻(Forrest 2c或3)、CCI评分小于3、无消化性溃疡病史、无CVD病史或入院INR≤1.2的患者相比,一年内因PUB再次入院的可能性分别更高。

结论

本研究证实年龄(≥70岁)、Forest分级(Forrest 1a、1b、2a或2b)、多种合并症、消化性溃疡病史、CVD病史和入院INR>1.2是患者一年内因复发性PUB再次入院的独立危险因素。

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