ICU 患者消化道出血的发生率和风险因素:一项为期四年的队列研究

Ali Sadie Alhashemi, Hasanain Abdul-Muhsin, Ahmed Amer Abdul Hussein
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摘要

本研究旨在调查重症监护病房(ICU)中消化道出血(GIB)的频率和潜在原因,同时关注相关的风险因素。研究以队列研究的形式在伊拉克巴格达加齐-哈里里特殊外科教学医院(Ghazi AL Hariri Teaching Hospital for Special Surgeries)和医疗城综合体烧伤专科教学医院(Burn Specialty Teaching Hospital at Medical City Complex)的重症监护中心进行,时间跨度为2018年至2022年,研究采用单变量和多变量干预分析方法对重症监护病房入院时出现临床意义明显的胃肠道出血的患者进行了分析。主要研究结果显示,1.3%的重症监护病房病例在之前没有症状的情况下发生了GIB,风险因素包括重症监护病房住院时间延长、肌酐水平升高、胆红素升高和天冬氨酸氨基转移酶活性升高。令人担忧的是,47% 的确诊 GIB ICU 患者在住院期间面临死亡,明显高于非 GIB 患者(30%)。这项研究强调了对高危患者保持警惕和早期发现的重要性,因为尽管GIB的发病率在下降,但ICU人群中GIB的发病率和死亡率却很高。 亮点:这项队列研究调查了 ICU 患者消化道出血(GIB)的频率和相关风险因素。 研究发现,ICU 病程延长、肌酐和胆红素水平升高以及天冬氨酸氨基转移酶活性升高是 GIB 发生的风险因素。 令人担忧的是,确诊为 GIB 的 ICU 患者的死亡率(47%)明显高于未确诊为 GIB 的患者(30%),这凸显了早期发现和警惕这种疾病的重要性。 关键词:胃肠道出血胃肠道出血 重症监护病房 风险因素 死亡率 队列研究
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Incidence and Risk Factors of Gastrointestinal Bleeding in ICU Patients: A Four-Year Cohort Study
This study aims to investigate the frequency and potential causes of gastrointestinal bleeding (GIB) in Intensive Care Units (ICUs) while focusing on the associated risk factors. Conducted as a cohort study in critical care centers at Ghazi AL Hariri Teaching Hospital for Special Surgeries and Burn Specialty Teaching Hospital at Medical City Complex in Baghdad, Iraq, spanning from 2018 to 2022, the research analyzed patients with clinically significant GIB upon admission to the ICU using univariate and multivariate intervention analyses. The key findings revealed that 1.3% of ICU cases developed GIB without prior symptoms, with risk factors including prolonged ICU stays, elevated creatinine levels, elevated bilirubin, and heightened Aspartate Aminotransferase activity. Alarmingly, 47% of GIB-diagnosed ICU patients faced mortality during their hospitalization, significantly higher than non-GIB patients (30%). This study underscores the importance of vigilance and early detection for high-risk patients, given the significant morbidity and mortality associated with GIB in the ICU population, despite its declining incidence. Highlights :  This cohort study investigates the frequency and risk factors associated with gastrointestinal bleeding (GIB) in ICU patients. Prolonged ICU stays, elevated creatinine and bilirubin levels, and increased Aspartate Aminotransferase activity are identified as risk factors for GIB development. Alarmingly, GIB-diagnosed ICU patients have a significantly higher mortality rate (47%) compared to non-GIB patients (30%), highlighting the critical importance of early detection and vigilance in managing this condition. Keywords: Gastrointestinal Bleeding, Intensive Care Units, Risk Factors, Mortality, Cohort Study
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