Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2020
Medical care setting is associated with survival in acute upper gastro-intestinal bleeding: A cohort study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Marmo Riccardo, Soncini Marco, Marmo Clelia, Borbjerg Laursen Stig, Gralnek Ian Mark, Stanley Adrian J
Аннотация
BACKGROUND: There are limited data on the effect of the medical care setting on survival in patients admitted with acute upper gastrointestinal bleeding.
AIMS: To identify the organisational and care setting which provides the optimal survival in patients with acute upper gastrointestinal bleeding.
METHODS: A retrospective observational study of administrative data from a cohort of patients admitted to a Regional or Local hospital, and cared for in a gastroenterology or general ward.
PRIMARY OUTCOME: 30 day survival for non-variceal bleeding and 42 day survival for variceal bleeding.
RESULTS: Out of 3368 patients, the source of bleeding was non-variceal in 2980 (88.5%). Survival, adjusted for clinical and organisational factors, was higher in patients admitted to a gastroenterology ward vs other wards (OR = 2.02 p < 0.0006). Management in a gastroenterology ward in a Regional hospital provided a higher survival rate (95.6% ± 0.08) vs a non-gastroenterology ward in a Local hospital (92.9% ± 0.05 p < 0.01) or a non-gastroenterology ward in a Regional hospital (89.5% ± 0.01 p < 0.0001). Survival (94.0% ± 1.6) in a Local hospital with a gastroenterology ward was significantly higher than in a Regional hospital without (89.5% ± 1.1) p < 0.01.
CONCLUSION: Survival was optimal for patients treated in a gastroenterology ward independently of Regional or Local hospital setting.
AIMS: To identify the organisational and care setting which provides the optimal survival in patients with acute upper gastrointestinal bleeding.
METHODS: A retrospective observational study of administrative data from a cohort of patients admitted to a Regional or Local hospital, and cared for in a gastroenterology or general ward.
PRIMARY OUTCOME: 30 day survival for non-variceal bleeding and 42 day survival for variceal bleeding.
RESULTS: Out of 3368 patients, the source of bleeding was non-variceal in 2980 (88.5%). Survival, adjusted for clinical and organisational factors, was higher in patients admitted to a gastroenterology ward vs other wards (OR = 2.02 p < 0.0006). Management in a gastroenterology ward in a Regional hospital provided a higher survival rate (95.6% ± 0.08) vs a non-gastroenterology ward in a Local hospital (92.9% ± 0.05 p < 0.01) or a non-gastroenterology ward in a Regional hospital (89.5% ± 0.01 p < 0.0001). Survival (94.0% ± 1.6) in a Local hospital with a gastroenterology ward was significantly higher than in a Regional hospital without (89.5% ± 1.1) p < 0.01.
CONCLUSION: Survival was optimal for patients treated in a gastroenterology ward independently of Regional or Local hospital setting.