评分系统在预测老年患者上部胃肠道出血的死亡率方面是否有用?
Mustafa Zanyar Akkuzu1, Berat Ebik1
1Department of Gastroenterology, Diyarbakır Gazi Yasargil Education and Research Hospital, University of Health Sciences, Diyarbakır 21070, Turkey.
Diagnostics (Basel, Switzerland)
|September 13, 2025
概括
高位肠道上部出血的老年患者的住院死亡率很高,特别是由于败血症和恶性瘤. 艾姆斯65和罗卡尔分数有效预测这些高风险个体的死亡风险.
科学领域:
- 老年医学 老年医学
- 胃肠病学 胃肠病学
- 临床流行病学临床流行病学
背景情况:
- 上部胃肠道 (GI) 出血对患有并发症的老年患者构成重大风险.
- 确定死亡率和预测因素对于管理这种脆弱人口至关重要.
研究的目的:
- 确定患上上肠道上部出血的老年患者的住院死亡率.
- 确定AIMS65和Rockall得分的有效切断值,以预测高风险患者.
- 评估口服抗凝剂和NSAID使用对死亡率的影响.
主要方法:
- 一项回顾性队列研究,涉及64名老年患者 (≥60岁) 患上上肠道上部出血的并发病.
- 计算所有参与者的AIMS65和Rockall分数.
- 包括ROC分析和Kaplan-Meier生存曲线在内的统计分析,以评估得分有效性和药物影响.
主要成果:
- 住院死亡率为18.7%. 败血症,恶性瘤和心力衰竭是死亡率的重要预测因素.
- 艾姆斯65评分≥2 (AUC=0.920) 和罗卡尔评分≥6 (AUC=0.822) 显示在预测死亡率方面具有高度敏感性和有效性.
- 在死亡率和使用口服抗凝剂或NSAID之间没有发现显著的关联.
结论:
- 高龄患者患有并发症的上肠道出血具有高的住院死亡率,主要是由败血症,恶性瘤和心力衰竭驱动的.
- 艾姆斯65和罗卡尔分数是预测死亡率的有价值工具,可能使早期干预成为可能.
- 该研究强调了由于小,高风险队列的多中心验证的需要.
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