INCIDENCE OF AND MORTALITY FROM ACUTE UPPER GASTROINTESTINAL HEMORRHAGE IN THE UNITED-KINGDOM
INCIDENCE OF AND MORTALITY FROM ACUTE UPPER GASTROINTESTINAL HEMORRHAGE IN THE UNITED-KINGDOM
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DOI：
10.1136/bmj.311.6999.222
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发表时间：
1995-07-22
影响因子：
--
通讯作者：
NORTHFIELD, TC
中科院分区：
文献类型：
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作者：
ROCKALL, TA;LOGAN, RFA;NORTHFIELD, TC
描述急性上消化道出血的当前流行病学，设计-基于人群的、多中心、前瞻性调查，设置-英国四个卫生区域的74家接受急诊入院的医院，受试者-在四个月内确定的4185例急性上消化道出血病例，其中患者年龄超过16岁，结果测量发病率和mortals.Results-The急性上消化道出血的总发病率在英国是103/100 000成人每年，发病率上升，从23岁以下的那些30岁至485岁以上的那些75。在所有年龄段，男性的发病率是女性的两倍以上，老年患者除外，14%的出血发生在因其他原因住院的住院患者中，27%的病例（37%女性，19%男性）患者年龄超过80岁。总死亡率为14%（急诊入院11%，住院患者出血33%），在急诊入院中，80岁以下患者中65%的死亡与恶性肿瘤或器官衰竭有关，60岁以下的患者，如果没有恶性肿瘤或器官衰竭，死亡率为0.8%。急性上消化道出血的发病率是以前在英格兰报道的两倍，与苏格兰报道的相似，发病率随着年龄的增长而明显增加，尽管老年患者的比例继续上升，死亡率随着年龄的增长而急剧增加，年龄标准化死亡率低于早期研究，死亡几乎完全发生在非常老的患者或患有严重合并症的患者中。
Objective-To describe the current epidemiology of acute upper gastrointestinal haemorrhage,Design-Population based, unselected, multicentre, prospective survey,Setting-74 hospitals receiving emergency admissions in four health regions in the United Kingdom,Subjects-4185 cases of acute upper gastrointestinal haemorrhage in which patients were aged over 16 years identified over four months,Outcome measures-Incidence and mortality.Results-The overall incidence of acute upper gastrointestinal haemorrhage in the United Kingdom is 103/100 000 adults per year, The incidence rises from 23 in those aged under 30 to 485 in those aged over 75. At all ages incidence in men was more than double that in women except in elderly patients, 14% of the haemorrhages occurred in inpatients already in hospital for some other reason, In 27% of cases (37% female, 19% male) patients were aged over 80. Overall mortality was 14% (11% in emergency admissions and 33% in haemorrhage in inpatients), In the emergency admissions, 65% of deaths in those aged under 80 were associated with malignancy or organ failure at presentation, Mortality for patients under 60 in the absence of malignancy or organ failure at presentation was 0.8%.Conclusions-The incidence of acute upper gastrointestinal haemorrhage is twice that previously reported in England and similar to that reported in Scotland, The incidence increases appreciably with age, Although the proportion of elderly patients continues to rise and mortality increases steeply with age, age standardised mortality is lower than in earlier studies, Deaths occurred almost exclusively in very old patients or those with severe comorbidity.