肝硬化如何影响死亡率,发病率和资源利用率在非的上部胃肠道出血? 一个全国性的分析分析
Umer Farooq1, Zahid Ijaz Tarar2, Adnan Malik3
1Department of Internal Medicine, Loyola Medicine/MacNeal Hospital Berwyn, IL, USA.
Przeglad gastroenterologiczny
|August 4, 2023
概括
患有肝硬化的患者经历非静脉上胃肠道出血 (NVUGIB),面临更高的死亡率和重症监护室 (ICU) 住院率. 尽管住院时间较短,但这些患者的医疗费用较高,这突显了NVUGIB在肝硬化中的重大负担.
科学领域:
- 胃肠病学 胃肠病学
- 肝病学 肝病学是一种肝病学.
- 内部医学 内部医学
背景情况:
- 上部胃肠道出血是肝硬化患者的常见并发症.
- 虽然已经研究了肝病对非变节上部胃肠道出血 (NVUGIB) 的影响,但直接的子组比较是有限的.
- 了解NVUGIB在肝硬化中的特异性结果对于患者管理至关重要.
研究的目的:
- 为了研究非静脉上部胃肠道出血 (NVUGIB) 对诊断为肝硬化患者的医院结局的影响.
- 为了比较NVUGIB患者与肝硬化患者之间的死亡率,发病率和医疗保健资源利用率.
- 为了确定NVUGIB的肝硬化患者的死亡率预测因素.
主要方法:
- 用国际疾病分类 (ICD-10) 代码对全国住院样本 (NIS) 数据库进行了回顾性分析.
- 医院结局的比较,包括死亡率,发病率和资源利用率,对于NVUGIB的成年患者,按肝硬化状态分层.
- 统计分析包括费舍尔对比例的精确测试,学生对连续变量的t测试,以及倾向匹配,多变量后勤学和线性回归用于混变量调整.
主要成果:
- 与非肝硬化患者相比,患有NVUGIB的肝硬化患者的调整后死亡率 (AOR 1.31) 和ICU入院率 (AOR 1.29) 显著更高.
- 肝硬化患者的住院时间 (LOS) 缩短了0.44天,但每日住院费用 (3114美元与2810美元) 较高.
- 在肝硬化患者中观察到急性损伤的几率较低 (AOR 0.81),接受内镜治疗的几率较高 (AOR 1.08);在输血,腹腔营养,冲击或输管要求方面没有发现差异.
结论:
- 肝硬化显著增加了与非的上部胃肠道出血相关的死亡率和发病率负担.
- 肝硬化和NVUGIB患者表现出更大的医疗保健资源利用率,尽管住院时间较短.
- 这些发现强调了对NVUGIB在肝硬化患者群体中优化管理策略的迫切需要.
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