Alimentary pharmacology & therapeutics · 2020
Upper gastrointestinal bleeding in Scotland 2000-2015: trends in demographics, aetiology and outcomes.
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Chaudhary Sardar, Mackay Daniel, Pell Jill P, Morris John, Church Nicholas I, Fraser Andrew, Stanley Adrian J
Аннотация
BACKGROUND: Upper gastrointestinal bleeding (UGIB) remains a common cause of presentation and admission to hospital in the UK, with the incidence in Scotland one of the highest in the world.
AIMS: To investigate the difference in demographics, deprivation quintiles, aetiology of bleeding and clinical outcomes in patients presenting with UGIB to hospitals across Scotland over a 16-year period METHODS: Data were collected using the National Data Catalogue and analysed retrospectively using the National Safe Haven.
RESULTS: We included 129 404 patients. The annual number of patients presenting with UGIB remained similar over the 16-year period. Mean age at admission increased from 59.2 to 61.4 years. There was a significant drop in variceal bleeding over time from 2.2% to 1.7% (P < 0.001). The incidence of UGIB was highest in the more deprived quintiles. There was a significant decrease in 30-day case-fatality from 10.1% in 2000 to 7.9% in 2015 (P < 0.001), which was observed across all deprivation quintiles. Mean length of stay fell from 3.9 to 2.1 days. There was no difference in 30-day case-fatality or mean length of stay between patients presenting on weekdays or at weekends.
CONCLUSIONS: In this national study, we demonstrated that case-fatality and mean length of stay after presentation with UGIB in Scotland has fallen over the past 16 years, despite a rise the in mean age of patients. There is a positive correlation between the incidence of UGIB and deprivation. We found no evidence of worse outcomes among patients presenting at weekends.
AIMS: To investigate the difference in demographics, deprivation quintiles, aetiology of bleeding and clinical outcomes in patients presenting with UGIB to hospitals across Scotland over a 16-year period METHODS: Data were collected using the National Data Catalogue and analysed retrospectively using the National Safe Haven.
RESULTS: We included 129 404 patients. The annual number of patients presenting with UGIB remained similar over the 16-year period. Mean age at admission increased from 59.2 to 61.4 years. There was a significant drop in variceal bleeding over time from 2.2% to 1.7% (P < 0.001). The incidence of UGIB was highest in the more deprived quintiles. There was a significant decrease in 30-day case-fatality from 10.1% in 2000 to 7.9% in 2015 (P < 0.001), which was observed across all deprivation quintiles. Mean length of stay fell from 3.9 to 2.1 days. There was no difference in 30-day case-fatality or mean length of stay between patients presenting on weekdays or at weekends.
CONCLUSIONS: In this national study, we demonstrated that case-fatality and mean length of stay after presentation with UGIB in Scotland has fallen over the past 16 years, despite a rise the in mean age of patients. There is a positive correlation between the incidence of UGIB and deprivation. We found no evidence of worse outcomes among patients presenting at weekends.