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ナカムラ シンイチ
NAKAMURA Shinichi
中村 真一 所属 医学部 医学科（東京女子医科大学病院） 職種 教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Characteristics, Outcomes, and Risk Factors for Upper Gastrointestinal Bleeding in Inpatients - A Comparison with Outpatients |
| 掲載誌名 | 正式名：Internal medicine 略 称：Intern Med ISSNコード：13497235/09182918 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 62(10),pp.1395-1404 |
| 著者・共著者 | KOBAYASHI Ayako, KISHINO Maiko*, MISUMI Yoshitsugu, NAKAMURA Shinichi, NONAKA Kouichi, TOKUSHIGE Katsutoshi |
| 発行年月 | 2023/05 |
| 概要 | Objective The study objectives were to clarify the clinical findings and the causes of intractability and mortality of upper gastrointestinal (UGI) bleeding in inpatients. Methods The patients were divided into Inpatient (Ip) and Outpatient (Op) onset groups, and their characteristics, clinical and bleeding data, and outcomes were compared. Patients Our study included 375 patients who developed UGI bleeding during hospitalization or were admitted after being diagnosed with UGI bleeding in an outpatient setting from January 1, 2015, to June 30, 2020. Results The Ip group had worse general condition; increased percentages of comorbidities; and more common use of proton pump inhibitor, anti-coagulant, and steroid than the Op group. Compared with the Op group, the Ip group had lower serum albumin levels and platelet counts at the onset of bleeding, whereas rebleeding, mortality, and bleeding-related death rates were higher. Multivariate analysis of the Ip group revealed that the risks of rebleeding included endoscopic high-risk stigmata, maintenance dialysis, and duodenal bleeding, whereas the risks of mortality were gastric ulcer and a Charlson Comorbidity Index update score of ≥3. Conclusion UGI bleeding in the Ip group was associated with higher rebleeding and mortality rates. Because of their poor general health condition, the pathology of UGI bleeding in these patients may differ from that of patients with common UGI bleeding. A different approach for the care and prevention of UGI bleeding in inpatients is required. |
| DOI | 10.2169/internalmedicine.0614-22 |
| PMID | 36198601 |