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老年消化性溃疡出血患者的短期和长期病程——影响致命结局的因素分析

Short and long term course of elderly patients with peptic ulcer bleeding--analysis of factors influencing fatal outcome.

作者信息

Hasselgren G, Blomqvist A, Eriksson S, Henningsson A, Lundell L

机构信息

Department of Surgery, Sahlgren University Hospital, Göteborg, Sweden.

出版信息

Eur J Surg. 1998 Sep;164(9):685-91. doi: 10.1080/110241598750005570.

Abstract

OBJECTIVE

To study long and short term survival in patients aged 60 years or over admitted with a peptic ulcer bleeding and find out which factors influence outcome.

DESIGN

Cohort study with matched controls.

SETTING

Two emergency hospitals, Sweden

PATIENTS

676 of the 687 patients aged 60 years or over admitted to the two emergency hospitals serving Gothenburg, Sweden during 1989-1993 who fulfilled the diagnostic criteria and whose case notes were available for study.

MAIN OUTCOME MEASURES

Seven year survival rates and odds ratios for risk factors based on multiple logistic regression analyses.

RESULTS

37 patients died and the timing was evenly distributed within the first 30 days of admission with a cumulated case-fatality rate of 5.5% at day 30. Mortality was increased among the patients compared with the control group during the subsequent years. Factors that influenced day 30 mortality were age and Forrest class.

CONCLUSION

Mortality is increased among patients with peptic ulcer bleeding even long after the event. Old age and signs of recent haemorrhage increase the risk.

摘要

目的

研究60岁及以上因消化性溃疡出血入院患者的长期和短期生存率,并找出哪些因素会影响预后。

设计

配对对照队列研究。

地点

瑞典两家急诊医院

患者

1989年至1993年期间,在瑞典哥德堡的两家急诊医院收治的687例60岁及以上患者中,676例符合诊断标准且病历可供研究。

主要观察指标

基于多因素逻辑回归分析的七年生存率和危险因素的比值比。

结果

37例患者死亡,死亡时间在入院后的前30天内分布均匀,第30天的累计病死率为5.5%。在随后几年中,与对照组相比,患者的死亡率有所增加。影响第30天死亡率的因素是年龄和福里斯特分级。

结论

即使在事件发生很久之后,消化性溃疡出血患者的死亡率仍会增加。老年和近期出血迹象会增加风险。

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