Epidemiology and course of acute upper gastro-intestinal haemorrhage in four French geographical areas
Epidemiology and course of acute upper gastro-intestinal haemorrhage in four French geographical areas
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DOI：
10.1097/00042737-200012020-00007
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发表时间：
2000-02-01
影响因子：
2.1
通讯作者：
Colin, R
中科院分区：
文献类型：
--
作者：
Czernichow, P;Hochain, P;Colin, R
目的比较1996年法国急性上消化道出血（AUGIH）的发病率和流行病学特征。方法采用多中心前瞻性调查方法，对1996年法国4个行政区的29家公立医院和96名私人胃肠病专家进行调查。结果在法国的总发病率为143例/10万人/年，分为门诊（16%），急诊（59%）和住院（25%）。除住院患者外，其发病率随年龄增长而增加，且男性发病率较高。消化性溃疡（36.6%）、静脉曲张（13.7%）和糜烂性疾病（12.3%）是最常见的诊断。677例患者（31.7%）在出血前7天服用阿司匹林、肾上腺皮质激素或抗心律失常药物。总死亡率（不包括门诊患者）为14.3%（急诊患者为10.7%，住院患者为23%）。死亡率与合并症（特别是恶性肿瘤，肝硬化，哮喘或呼吸功能不全），是较低的急诊患者使用非类固醇抗炎药，和较高的住院患者使用皮质类固醇。结论在法国，AUGIH患者经常管理门诊病人。胃毒性药物的使用通常与AUGIH相关，并构成预防性治疗的战略机会。国家之间的差异无法通过人口因素或药物使用来明确解释，但这可能与强调住院患者的AUGIH有关。Eur J Gastroenterol Hepatol 12：175-181（C）2000 Lippincott威廉姆斯& Wilkins.
Objective To compare incidence rates and epidemiological characteristics of acute upper gastrointestinal haemorrhage (AUGIH) in France with those of other European studies.Design Population-based multi-centre prospective survey.Setting 29 public hospitals and 96 private specialists in gastroenterology in four administrative areas in France during 1996.Subjects A total of 2133 AUGIH patients 18 years and over were included in the six-month study.Outcome measures Incidence and mortality,Results The overall incidence in France was 143 cases per 100 000 persons per year, classified as out-patients (16%), emergency admissions (59%) and in-patients (25%). The incidence rates increased with age except for in-patients, and were higher in males. Peptic ulcer (36.6%), varices (13.7%) and erosive disease (12.3%) were the most frequent diagnoses, In 677 patients (31.7%), aspirin, antiinflammatory drugs or corticosteroids were taken on the 7 days before bleeding. The overall mortality tout-patients excluded) was 14.3% (10.7% for emergency patients and 23% for in-patients). Mortality was associated with comorbidities (especially malignancies, cirrhosis, asthma or respiratory deficiency), was lower in emergency patients using non-steroid anti-inflammatory drugs, and higher in in-patients using corticosteroids.Conclusions In France, patients with AUGIH are frequently managed as out-patients. Gastrotoxic drug use is frequently associated with AUGIH and constitutes a strategic opportunity for preventive treatment. Discrepancies between countries are not clearly explained either by demographic factors or by drug use, but this may be related to the emphasis on AUGIH in in-patients. Eur J Gastroenterol Hepatol 12:175-181 (C) 2000 Lippincott Williams & Wilkins.