背景:下消化道出血(LGIB)是急诊就诊和随后住院的常见原因。最近的数据表明,低危患者可以作为门诊病人进行安全评估。尚未建立针对医疗保健系统的建议,以确定可以通过及时的门诊随访安全出院的低风险患者。这项研究的主要目的是确定患者预测因子对LGIB患者接受紧急内镜干预的作用。
方法:对142例患者进行回顾性分析。收集了患者人口统计学数据,临床特征,合并症,药物,血液动力学参数,实验室值,和诊断成像。Logistic回归分析,独立样本t检验,MannWhitneyU检验非参数数据,通过卡方检验对分类变量进行单变量分析,以确定数据内的关系。
结果:关于逻辑回归分析,血红蛋白下降>20g/L是预测内镜干预的唯一变量(p=0.030)。心动过速,低血压,或抗凝治疗与内镜干预无显著相关性(p>0.05)。
结论:血红蛋白下降>20g/L是预测急诊科需要紧急内镜干预的唯一患者参数。
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common reason for emergency department visits and subsequent hospitalizations. Recent data suggests that low-risk patients may be safely evaluated as an outpatient. Recommendations for healthcare systems to identify low-risk patients who can be safely discharged with timely outpatient follow-up have yet to be established. The primary objective of this study was to determine the role of patient predictors for the patients with LGIB to receive urgent endoscopic intervention.
METHODS: A retrospective chart
review was performed on 142 patients. Data was collected on patient demographics, clinical features, comorbidities, medications, hemodynamic parameters, laboratory values, and diagnostic imaging. Logistic regression analysis, independent samples t-testing, Mann Whitney U testing for non-parametric data, and univariate analysis of categorical variables by Chi square test was performed to determine relationships within the data.
RESULTS: On logistic regression analysis, A hemoglobin drop of > 20 g/L was the only variable that predicted endoscopic intervention (p = 0.030). Tachycardia, hypotension, or presence of anticoagulation were not significantly associated with endoscopic intervention (p > 0.05).
CONCLUSIONS: A hemoglobin drop of > 20 g/L was the only patient parameter that predicted the need for urgent endoscopic intervention in the emergency department.