Masson J, Bramley P N, Herd K, McKnight G M, Park K, Brunt P W, McKinlay A W, Sinclair T S, Mowat N A
Aberdeen Royal Infirmary.
J R Coll Physicians Lond. 1996 Sep-Oct;30(5):436-42.
The open-access high dependency bleeding unit in Aberdeen admits all patients with suspected gastrointestinal bleeding from a stable adult population of 468,000. The aim is to reduce mortality, morbidity and hospital stay, and create a prospective whole community database. An agreed management protocol is based on prompt resuscitation and early diagnosis. From October 1991 to September 1993 there were 1,602 consecutive admissions with suspected upper or lower gastrointestinal haemorrhage. Bleeding was confirmed in 1,098 of 1,324 patients with presumed upper gastrointestinal haemorrhage, (117 bleeding episodes per 100,000 per year). The overall 30-day mortality was 3.9%, with all deaths attributable to significant concurrent illness. Mortality from peptic ulcer bleeding was 5.3%, with an operation rate of 17% and surgical mortality of 8%. Rapid diagnosis allowed 48% of 523 patients with trivial bleeds to be discharged after a median stay of 24 hours. Centralised expertise and equipment is the essence of the unit's success. The interests of patient care are better served, nursing skills are better developed and teaching opportunities better structured. The major improvement in clinical care, welcomed by hospital colleagues, management and general practitioners, makes the unit an indispensable part of acute medical provision.
阿伯丁的开放式高依赖出血治疗单元接收来自46.8万稳定成年人群中所有疑似胃肠道出血的患者。其目标是降低死亡率、发病率及缩短住院时间，并创建一个前瞻性的全社区数据库。商定的管理方案基于迅速复苏和早期诊断。从1991年10月至1993年9月，共有1602例连续入院的疑似上消化道或下消化道出血患者。在1324例推测为上消化道出血的患者中，1098例出血得到确诊（每年每10万人中有117次出血发作）。30天总体死亡率为3.9%，所有死亡均归因于严重的并发疾病。消化性溃疡出血的死亡率为5.3%，手术率为17%，手术死亡率为8%。快速诊断使523例轻度出血患者中有48%在中位住院24小时后出院。集中的专业知识和设备是该治疗单元成功的关键。患者护理的利益得到了更好的保障，护理技能得到了更好的发展，教学机会也得到了更好的安排。临床护理的重大改善受到了医院同事、管理层和全科医生的欢迎，使该治疗单元成为急性医疗服务中不可或缺的一部分。
