Altaca G, Dereli Z, Sayek I, Karaağaoğlu E
Bayindir Medical Center, Department of General Surgery, Ankara, Turquey.
Acta Chir Belg. 1994 Sep-Oct;94(5):263-5.
Forty-five patients with acute gastric mucosal lesions (AGML), operated on in a 15-year period (1976-1990) were retrospectively analyzed to assess the factors affecting the mortality. The operative mortality rate was 37.78%. Univariate and multivariate analysis were done to demonstrate if any of the previously derived set of 15 clinical variables was related to the operative mortality. The clinical variables used were age, sex, indication of initial hospitalization, hypotension, recent operation, NSAID use, AGML prophylaxis, transfusion, recent upper Gl bleeding, concurrent major medical illness, concurrent sepsis, type of operation, postoperative complication, rebleeding, and reoperation for AGML. Mean age, major medical illness, postoperative complication, rebleeding, and reoperation were found to affect the prognosis according to the univariate analysis. Only postoperative complication and concurrent major medical illness were significant factors affecting the mortality when multivariate analysis was done. Further analysis showed that concurrent major medical illness and initial indication of hospitalization were the significant factors among the studied variables affecting the postoperative complication rate. The type of operation did not alter the prognosis.
对1976年至1990年这15年间接受手术治疗的45例急性胃黏膜病变(AGML)患者进行回顾性分析,以评估影响死亡率的因素。手术死亡率为37.78%。进行单因素和多因素分析,以确定先前得出的15个临床变量中的任何一个是否与手术死亡率相关。所使用的临床变量包括年龄、性别、初次住院指征、低血压、近期手术、非甾体抗炎药使用情况、AGML预防措施、输血、近期上消化道出血、并发重大内科疾病、并发败血症、手术类型、术后并发症、再出血以及因AGML再次手术。单因素分析发现,平均年龄、重大内科疾病、术后并发症、再出血和再次手术会影响预后。进行多因素分析时,只有术后并发症和并发重大内科疾病是影响死亡率的显著因素。进一步分析表明,在研究的变量中,并发重大内科疾病和初次住院指征是影响术后并发症发生率的显著因素。手术类型并未改变预后。