Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting.
Upper gastrointestinal bleeding: incidence, etiology and outcomes in a population-based setting.
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DOI：
10.3109/00365521.2012.763174
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发表时间：
2013-04
影响因子：
1.9
通讯作者：
Björnsson ES
中科院分区：
文献类型：
--
作者：
Hreinsson JP;Kalaitzakis E;Gudmundsson S;Björnsson ES
作者旨在研究急性上消化道出血（AUGIB）的发生率和结局，并检查可能与AUGIB相关的药物的作用。 该研究是前瞻性的，基于人群的，包括2010年在冰岛国立大学医院接受上消化道内镜检查（UGE）的所有患者。前瞻性登记了GIB前NSAID、低剂量阿司匹林（LDA）、华法林、SSRI和双膦酸盐的药物摄入，并在涵盖冰岛所有处方的药物数据库中进行了检查。年龄和性别匹配的对照组由在研究期间接受UGE且没有GIB的患者组成。共有1731例患者接受了2058次UGE。总体而言，156例患者接受了AUGIB。AUGIB的粗发病率为每年87/100，000居民。最常见的病因是十二指肠溃疡（21%）和胃溃疡（15%）。出血者中LDA（40% vs. 30%）、NSAID（20% vs. 8%）、华法林（15% vs. 7%）、NSAID + LDA（8% vs. 1%）和SSRI + LDA（8% vs. 3%）的联合用药显著高于非出血者。3例患者（1.9%）接受了急诊手术，2例患者死于AUGIB。临床显著出血的独立预测因素是胃溃疡（OR 6.6，p = 0.012）和非甾体抗炎药（OR 6.6，p = 0.004）。LDA、NSAID和华法林在AUGIB病因学中起重要作用，特别是药物组合。胃溃疡和非甾体抗炎药是严重出血的独立预测因素。住院期间的死亡率和手术需求在该人群中较低。
The authors aimed to investigate the incidence and outcomes of acute upper gastrointestinal bleeding (AUGIB) and to examine the role of drugs potentially associated with AUGIB. The study was prospective, population-based and consisted of all patients who underwent upper gastrointestinal endoscopy (UGE), during the year of 2010 at the National University Hospital of Iceland. Drug intake of NSAIDs, low-dose aspirin (LDA), warfarin, SSRIs and bisphosphonates prior to GIB was prospectively registered and also checked in a Pharmaceutical Database covering all prescriptions in Iceland. An age- and gender-matched control group consisted of patients who underwent UGE during the study period and were without GIB. A total of 1731 patients underwent 2058 UGEs. Overall, 156 patients had AUGIB. The crude incidence for AUGIB was 87/100,000 inhabitants per year. The most common etiologies were duodenal (21%) and gastric ulcers (15%). Use of LDA (40% vs. 30%), NSAIDs (20% vs. 8%), warfarin (15% vs. 7%), combination of NSAIDs + LDA (8% vs. 1%) and SSRIs + LDA (8% vs. 3%) were significantly more common among bleeders than non-bleeders. Three patients (1.9%) had emergency surgery and two patients died of AUGIB. Independent predictors of clinically significant bleeding were gastric ulcer (OR 6.6, p = 0.012) and NSAIDs (OR 6.6, p = 0.004). LDA, NSAIDs and warfarin play an important role in AUGIB etiology and particularly combinations of drugs. Gastric ulcer and NSAIDs were independent predictors of severe bleeding. Mortality and the need for surgery during hospitalization was low in this population-based setting.
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影响因子：
--
作者：
ROCKALL, TA;LOGAN, RFA;NORTHFIELD, TC
通讯作者：
NORTHFIELD, TC
DOI：
10.1097/00042737-200012020-00007
发表时间：
2000-02-01
影响因子：
2.1
作者：
Czernichow, P;Hochain, P;Colin, R
通讯作者：
Colin, R
影响因子：
--
作者：
CARSON, JL;STROM, BL;MORSE, ML
通讯作者：
MORSE, ML
影响因子：
--
作者：
Donahue, JG;Chan, KA;Platt, R
通讯作者：
Platt, R
影响因子：
7.6
作者：
Etminan, M.;Levesque, L.;Brophy, J. M.
通讯作者：
Brophy, J. M.