北京部分地区10年中青年和老年上消化道出血病因流行病学分析及经济负担研究

Epidemiological analysis and economic burden of upper gastrointestinal bleeding in young and old aged patients in 10 years in Beijing

目的探讨北京部分地区10年间中青年和老年上消化道出血患者的病因特点,同时分析其临床治疗的经济负担状况及影响因素。方法回顾性分析1785例上消化道出血(UGIB)患者的临床资料,根据年龄分为中青年组(<60岁,981例)和老年组(≥60岁,804例),对比分析两组的发病原因及特点,进行总结和归纳;并应用多元线性回归模型分析两组患者的医疗费用情况及相关影响因素。结果上消化道出血患者中,两年龄组男性所占比例均高于女性,但两组间性别构成比无差别。不同季节上消化道出血患者所占比例存在差异,春秋两季略高于夏冬两季,但两组间不同季节患病构成比无差别。上消化道出血的发病原因主要是消化性溃疡(PU)、食管胃底静脉曲张破裂(EGV)、急性胃黏膜病变(AGML)及胃癌(GC);中青年组依次为PU、EGV、AGML、GC;老年组依次为PU、EGV、GC、AGML;其中,老年组胃溃疡(GU)、复合溃疡(CU)、GC、AGML构成比高于中青年组,而十二指肠溃疡(DU)构成比低于中青年组;EGV构成比两组间无差别。经济负担状况分析,中青年组住院天数、总医疗费用等均显著低于老年组,其影响因素主要是年龄、病情严重程度、住院天数、病因诊断、合并症数量及治疗方式。结论北京部分地区10年间中青年、老年上消化道出血患者中男性所占比例均高于女性,不同季节出血患者所占比例春秋两季略高于夏冬两季。消化性溃疡仍为上消化道出血的首要病因,此外中青年组依次为EGV、AGML、GC;老年组依次为EGV、GC、AGML。老年组GU、CU、GC、AGML构成比高于中青年组,而DU低于中青年组。中青年组患者经济负担轻于老年组,年龄、病情严重程度、住院天数、病因诊断、合并症数量及治疗方式为其主要影响因素。

Objective In parts of Beijing 10 years young and elderly on the causes of upper gastrointestinal bleeding summarize and generalize, analyze the characteristics of upper gastrointestinal bleeding in two age groups, and analyze the economic burden and influencing factors of the clinical treatment,in order to optimize clinical treatment programs,to reduce the financial burden of patients and society. Method Collected between January 2008 to January2018 in parts of the Beijing 1785 cases of upper gastrointestinal bleeding(UGIB) clinical data were retrospectively analyzed, divided according to the age of the younger group(<60 years old, 981 cases) and the elderly group(≥60 years old,804 cases) regression analysis of two groups of patients and medical expenses related factors and apply;comparative analysis of two groups of causes, and review and summarize. Result In patients with upper gastrointestinal bleeding, the proportion of male was higher than female, but there was no difference between two groups. The proportion of patients with upper gastrointestinal bleeding was different in different seasons. The proportion of patients was higher than that of summer and winter in different seasons, but there was no difference between two groups. The main causes of upper gastrointestinal bleeding were peptic ulcer(PU), EGV,AGML, GC, and GU,CU, GC, AGML, EGV were higher than those in the middle and young group, but DU was significantly lower than that in the middle and young age groups. The economic burden of the patients was significantly lower than that in the old age group. The effect factors were age,illness severity, length of stay, the number of patients and treatment.Conclusion In some areas of Beijing 10 years in youth, elderly upper gastrointestinal bleeding, in the proportion of male patients was higher than that in female, different seasons hemorrhage patients accounted for a proportion of the spring and autumn two season is slightly higher than that of summer and winter. Peptic ulcer still is the primary cause of upper digestive tract bleeding. In addition the youth group followed by EGV, AGML, GC; elderly group followed by EGV, GC, AGML. Old group GU,CU, GC, AGML constitute ratio is higher than in the young group,and DU is lower than that in young group. In young patients economic burden is lower than the older group, age,severity of disease,length of hospital stay, etiological diagnosis with disease and the number of The treatment method is the main influencing factor.