老年上消化道出血患者近期预后多因素分析

Risk factors for short-term prognosis in elderly patients with upper gastrointestinal bleeding

将2000年1月至2007年12月期间收住我院960岁的上消化道出血患者85例分为病死组（18例，出血30d内死亡）与存活组（67例），对比分析患者的病史、临床表现、并发症等特点，探讨近期死亡的影响因素。结果显示病死组心脑血管病、糖尿病、胃溃疡、血红蛋白、心律失常、胃癌、多器官功能障碍综合征（MODS）、休克者比例较多（P〈0．05或P〈0．01），最终进入logistic回归模型的因素有胃癌、MODS、休克。提示胃癌、MODS、休克并存是≥60岁老年上消化道出血患者近期预后的独立危险因素。

Eighty-five elderly patients treated for the upper gastrointestinal bleeding （UGB） in our hospital between January 2000 and December 2002 were divided into death or survival group. Their clinical characteristics, risk factors, treatment and complications were retrospectively analyzed. Eighteen patients died of UGB within 30 days. Univariate analysis indicated that documented diabetes, cardiovascular disease, cerebrovascular disease, gastric ulcer, hemoglobin, arrhythmia, stomach cancer, multiple organ dysfunction syndrome （MODS）, and shock were significantly associated with inhospital mortality within 30 days（P 〈0. 05 or P 〈 0.01 ）. Stomach cancer, MODS, and shock entered into the Logistic regression model. These findings demonstrate that stomach cancer, MODS, and shock might be independent risk factors for short-term prognosis in elderly UGB patients.