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PANG Xiufeng, SHI Bin, WANG Huanhuan, DAI Xiaoyong, HUO Yujie, CHEN Yongzhen, YE Youwen, ZHU Yuqin. Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
Citation: PANG Xiufeng, SHI Bin, WANG Huanhuan, DAI Xiaoyong, HUO Yujie, CHEN Yongzhen, YE Youwen, ZHU Yuqin. Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection[J]. Journal of Clinical Medicine in Practice, 2020, 24(22): 32-35,40. DOI: 10.7619/jcmp.202022009
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Analysis on clinical features and prognosis of acute upper gastrointestinal bleeding in aged patients with co-infection

  • Emergency Department, Yangpu District Central Hospital in Shanghai, Yangpu Hospital Affiliated to Tongji University, Shanghai, 200090

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  • Received Date: September 16, 2020
  • Available Online: December 21, 2020
  • Published Date: December 02, 2020
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    • Abstract
  • Objective To study the clinical characteristics and the influence of co-infection on prognosis of acute upper gastrointestinal bleeding(UGIB). Methods The clinical data of 260 elderly patients with acute UGIB were selected, and they were divided into infection group and non-infection group. Their clinical characteristics, etiology, treatment and prognosis were analyzed. At the same time, 170 patients with acute gastric mucosal lesions of 260 cases were divided into infected subgroup and non-infection subgroup, and receiver operating characteristic(ROC)curve was used to analyze the efficacy of laboratory indicators in predictingfatality rate. Results The incidence of shock, fibrinogen(FIB), white blood cell count(WBC), C-reactive protein(CRP)and procalcitonin(PCT)levels in the infection group were significantly higher than those in the non-infection group(P<0.05). However, there were no significant differences in fatality rate and other factors between the two groups(P>0.05). The mortality and shock rates of the infection subgroup were significantly higher than those of the non-infection subgroup, and activated partial thromboplastin time(APTT)and FIB levels were significantly higher than those of the non-infection subgroup(P<0.05). Among 260 elderly patients with acute UGIB, serum urea nitrogen was the only independent predictor associated with all-cause mortality, and was of great predictive value in the subgroups with acute gastric mucosal lesions. Conclusion The main etiology of acute UGIB in elderly patients in emergency department is acute gastric mucosal lesion, followed by tumor. Mortality and shock rates are higher in UGIB - patients with infection, and BUN level at admission is an independent predictor of all-cause mortality.
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  • FARRELL J J, FRIEDMAN L S. Gastrointestinal bleeding in the elderly[J]. Gastroenterol Clin North Am, 2001, 30: 377-407.
    LAINE L, YANG H, CHANG S C, et al. Trends for incidence of hospitalization and death due to GI complications in the United States from 2001 to 2009[J]. Am J Gastroenterol, 2012, 107: 1190-1195.
    LANAS A, DUMONCEAU J M, HUNT R H, et al. Non-variceal upper gastrointestinal bleeding[J]. Nat Rev Dis Primers, 2018, 19(4): 18020.
    BARDOU M, QUENOT J P, BARKUN A. Stress-related mucosal disease in the critically ill patient[J]. Nat Rev Gastroenterol Hepatol, 2015, 12(2): 98-107.
    SPIRT MJ, STANLEY S. Update on stress ulcer prophylaxis in critically ill patients[J]. Crit Care Nurse, 2006, 26: 18-20.
    GIBSON W, SCATURO N, ALLEN C. Acute Management of Upper Gastrointestinal Bleeding[J]. AACN Advanced Critical Care, 2018, 29(4): 369-376.
    SEGAL W N, CELLO J P. Hemorrhage in the upper gastrointestinal tract in the older patient[J]. Am J Gastroenterol, 1997, 92(1): 42-46.
    YANG Q Y, OUYANG J, YANG J D. Sepsis as an important risk factor for gastrointestinal bleeding in acute coronary syndrome patients: Two case reports[J]. Medicine, 2018, 97(36): e12273.
    SHIH H A, TSAI P C, WU K H, et al. Bacteremia in cirrhotic patients with upper gastrointestinal bleeding[J]. Turk J Gastroenterol, 2018, 29(2): 164-169.
    MOON A M, DOMINITZ J A, IOANNOU G N, et al. Use of antibiotics among patients with cirrhosis and upper gastrointestinal bleeding is associated with reduced mortality[J]. Clin Gastroenterol Hepatol, 2016, 14(11): 1629-1637.
    CASTILLO L, PRACHUAPTHUNYACHART S, HALL M, et al. Antibiotic use in cirrhotic children with acute upper gastrointestinal bleeding[J]. Medicine(Baltimore), 2019, 98(29): e16505.
    郝素华, 郝琳, 杨卫华, 等. 血清CEA、CA19-9、SCC-Ag、NSE、CYFRA21-1和ProGRP在肺癌诊断中的价值[J]. 中国肿瘤, 2012, 21(11): 852-855.
    KOAMI H, SAKAMOTO Y, SAKURAI R, et al. The thromboelastometric discrepancy between septic and trauma induced disseminated intravascular coagulation diagnosed by the scoring system from the Japanese association for acute medicine[J]. Medicine, 2016, 95(31): e4514.
    祖道明, 张 蕾. 感染性肺炎患儿FIB、PCT、hs-CRP水平的变化及意义[J]. 国际检验医学杂志, 2017, 38(5): 609-612.
    ARIHAN O, WERNLY B, LICHTENAUER M, et al. Blood Urea Nitrogen(BUN)is independently associated with mortality in critically ill patients admitted to ICU[J]. PLoS One, 2018, 13(1): e0191697.
    MURATA A, KASAI T, MATSUE Y, et al. Relationship between blood urea nitrogen-to-creatinine ratio at hospital admission and long-term mortality in patients with acute decompensated heart failure[J]. Heart Vessels, 2018, 33(8): 877-885.
    ADAM A M, NASIR S A R, MERCHANT A Z, et al. Efficacy of serum blood urea nitrogen, creatinine and electrolytes in the diagnosis and mortality risk assessment of patients with acute coronary syndrome[J]. Indian Heart J, 2018, 70(3): 353-359.
    GONZÁLEZ-GONZÁLEZ J A, MONREAL-ROBLES R, GARCÍA-COMPEAN D, et al. Nonvariceal upper gastrointestinal bleeding in elderly people: Clinical outcomes and prognostic factors[J]. J Dig Dis, 2017, 18(4): 212-221.
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