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Journal of Clinical and Nursing Research 2024年第7期8卷 303-309页

作者： Dalei Chen Affiliated Hospital of Hebei University Baoding 071000Hebei ProvinceChina

Objective:To analyze the risk factors for death during hospitalization in patients with acute myocardial infarction(AMI)complicated by gastrointestinal bleeding(GIB).Methods:260 patients with AMI complicated by GIB who were admitted to the cardiology department of a hospital from January 2022 to December 2023 were retrospectively analyzed.27 patients who died during hospitalization were designated as the control group and the 233 patients who survived as the observation *** data and clinical indexes of patients in the two groups were compared,and multifactorial logistic regression was applied to analyze the risk factors for death during hospitalization in patients with AMI complicated by ***:Univariate analysis showed that the control group had higher proportions of patients with Killip classification III to IV on admission,new arrhythmias,and mechanical complications,as well as higher heart rates,white blood cell counts,urea nitrogen,and creatinine *** proportion of patients who received transfusion therapy during hospitalization was also higher in the control ***,the control group had lower systolic and left ventricular ejection fraction rates compared to the observation group,with statistically significant differences(P100 beats/min(OR=3.824,95%CI 1.472-9.927),left ventricular ejection fraction100 beats/min,left ventricular ejection fraction<50%,elevated BUN levels,and blood transfusion are risk factors for death during hospitalization in patients with AMI complicated by GIB.

关键词： Acute myocardial infarction gastrointestinal haemorrhage Death Risk factors Anticoagulation Preventive strategies

gastrointestinal dysfunction is associated with mortality in severe burn patients:a 10-year retrospective observational study from South China

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Military Medical Research 2023年第3期10卷 299-312页

作者： Qiu-Lan He Shao-Wei Gao Ying Qin Run-Cheng Huang Cai-Yun Chen Fei Zhou Hong-Cheng Lin Wen-Qi Huang Department of Anesthesiology the First Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of Anesthesiology Zhongshan People's HospitalZhongshan 528400GuangdongChina Department of Anesthesiology Dongguan People's HospitalDongguan 523059GuangdongChina Department of Burn Surgery the First Affliated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of Colorectal Surgery the Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510655China

Background:Data on severe and extensive burns in China are limited,as is data on the prevalence of a range of related gastrointestinal(GI)disorders[such as stress ulcers,delayed defecation,opioid-related bowel immotility,and abdominal compartment syndrome(ACS)].We present a multicentre analysis of coincident GI dysfunction and its effect on burn-related ***:This retrospective analysis was conducted on patients with severe[≥20%total burn surface area(TBSA)]and extensive(>50%TBSA or>25%full-thickness TBSA)burns admitted to three university teaching institutions in China between January 1,2011 and December 31,*** 30-and 90-day mortality were assessed by collating demographic data,burn causes,admission TBSA,%full-thickness TBSA,Baux score,Abbreviated Burn Severity Index(ABSI)score,and Sequential Organ Failure Assessment(SOFA)score,shock at admission and the presence of an inhalation *** dysfunction included abdominal distension,nausea/vomiting,diarrhoea/constipation,GI ulcer/haemorrhage,paralytic ileus,feeding intolerance and ***,length of intensive care unit(ICU)stay,pain control[in morphine milligram equivalents(MME)]and overall length of hospital stay(LOHS)were ***:We analyzed 328 patients[75.6%male,mean age:(41.6±13.6)years]with a median TBSA of 62.0%(41.0%–80.0%);256(78.0%)patients presented with extensive *** 90-day mortality was 23.2%(76/328),with 64(84.2%)of these deaths occurring within 30 d and 25(32.9%)occurring within 7 *** dysfunction was experienced by 45.4%of patients and had a significant effect on 90-day mortality[odds ratio(OR)=14.070,95%confidence interval(CI)5.886–38.290,P<0.001].Multivariate analysis showed that GI dysfunction was associated with admission SOFA score and%full-thickness ***,88.2%(67/76)of deceased patients had GI dysfunction[hazard ratio(HR)for death of GI dysfunction=5.951],with a survival advantage for functional disorders(diarrhoea,constipation,or nausea/vomiting)ove

关键词： Severe burn gastrointestinal dysfunction Mortality Sepsis gastrointestinal haemorrhage Continuous analgesia

AIMS65: A promising upper gastrointestinal bleeding risk score but further validation required

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World Journal of Gastroenterology 2014年第39期20卷 14515-14516页

作者： Ray Boyapati Avik Majumdar Marcus Robertson Department of Gastroenterology and Liver Transplant Austin Hospital Heidelberg VIC 3084 Australia

A novel upper gastrointestinal bleeding risk stratification score(AIMS65) has recently been developed and validated. It has advantages over existing risk scores including being easy to remember and lack of subjectivity in calculation. We comment on a recent study that has cast doubt on the applicability of AIMS65 in the peptic ulcer disease population. Although promising, further studies are required to evaluate the validity of AIMS65 in various populations.

关键词： gastrointestinal haemorrhage AIMS65 Endoscopy Prognosis Hemostasis gastrointestinal bleeding

The global epidemiology of upper and lower gastrointestinal bleeding in general population:A systematic review

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World Journal of gastrointestinal Surgery 2023年第4期15卷 723-739页

作者： Şiir Su Saydam Megan Molnar Pareen Vora Integrated Evidence Generation Bayer AGBerlin 13353Germany

BACKGROUND gastrointestinal bleeding(GIB)is a common and potentially life-threatening clinical *** date,the literature on the long-term global epidemiology of GIB has not been systematically *** To systematically review the published literature on the worldwide epidemiology of upper and lower *** EMBASE®and MEDLINE were queried from 01 January 1965 to September 17,2019 to identify population-based studies reporting incidence,mortality,or casefatality rates of upper GIB(UGIB)or lower GIB(LGIB)in the general adult population,*** outcome data were extracted and summarized(including data on rebleeding following initial occurrence of GIB when available).All included studies were assessed for risk of bias based upon reporting *** Of 4203 retrieved database hits,41 studies were included,comprising a total of around 4.1 million patients with GIB worldwide from 1980–***-three studies reported rates for UGIB,four for LGIB,and four presented data on *** rates ranged from 15.0 to 172.0/100000 person-years for UGIB,and from 20.5 to 87.0/100000 person-years for *** studies reported on temporal trends,generally showing an overall decline in UGIB incidence over time,although a slight increase between 2003 and 2005 followed by a decline was shown in 5/13 ***-related mortality data were available from six studies for UGIB,with rates ranging from 0.9 to 9.8/100000 person-years,and from three studies for LGIB,with rates ranging from 0.8 to 3.5/100000 *** rate ranged from 0.7%to 4.8%for UGIB and 0.5%to 8.0%for *** of rebleeding ranged from 7.3%to 32.5%for UGIB and from 6.7%to 13.5%for *** main areas of potential bias were the differences in the operational GIB definition used and inadequate information on how missing data were *** Wide variation was seen in estimates of GIB epidemiology,likely due to high heterogeneity between studies however,UGIB sho

关键词： gastrointestinal bleeding gastrointestinal haemorrhage Epidemiology Incidence Mortality Case-fatality

Is the AIM65 score useful in predicting outcomes in peptic ulcer bleeding?

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World Journal of Gastroenterology 2014年第7期20卷 1846-1851页

作者： Sung Hoon Jung Jung Hwan Oh Hye Yeon Lee Joon Won Jeong Se Eun Go Chan Ran You Eun Jung Jeon Sang Wook Choi Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 130-709South Korea

AIM:To evaluate the applicability of AIMS65 scores in predicting outcomes of peptic ulcer ***:This was a retrospective study in a single center between January 2006 and December *** enrolled 522 patients with upper gastrointestinal haemorrhage who visited the emergency *** patients were regarded as those who had rebleeding within 30 d from the first endoscopy as well as those who died within 30 d of visiting the Emergency room.A total of 149 patients with peptic ulcer bleeding were analysed,and the AIMS65 score was used to retrospectively predict the high-risk ***:A total of 149 patients with peptic ulcer bleeding were *** poor outcome group comprised 28 patients[male:23(82.1%)vs female:5(10.7%)]while the good outcome group included 121patients[male:93(76.9%)vs female:28(23.1%)].The mean age in each group was not significantly *** mean serum albumin levels in the poor outcome group were slightly lower than those in the good outcome group(P=0.072).For the prediction of poor outcome,the AIMS65 score had a sensitivity of35.5%(95%CI:27.0-44.8)and a specificity of 82.1%(95%CI:63.1-93.9)at a score of *** AIMS65 score was insufficient for predicting outcomes in peptic ulcer bleeding(area under curve=0.571;95%CI:0.49-0.65).CONCLUSION:The AIMS65 score may therefore not be suitable for predicting clinical outcomes in peptic ulcer *** albumin levels may be a risk factor associated with high mortality in peptic ulcer bleeding.

关键词： gastrointestinal haemorrhage Peptic ulcer Mortality Morbidity Prognosis

Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

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World Journal of Radiology 2024年第5期16卷 115-127页

作者： Laura Maria Cacioppa Chiara Floridi Alessandra Bruno NicolòRossini Tommaso Valeri Alessandra Borgheresi Riccardo Inchingolo Francesco Cortese Giacomo Novelli Alessandro Felicioli Mario Torresi Pietro Boscarato Letizia Ottaviani Andrea Giovagnoni Division of Interventional Radiology Department of Radiological SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Department of Clinical Special and Dental SciencesUniversity Politecnica Delle MarcheAncona 60126Italy Division of Radiology Department of Radiological SciencesUniversity Hospital"Azienda Ospedaliero Universitaria Delle Marche"Ancona 60126Italy Interventional Radiology Unit "F Miulli"Regional General HospitalAcquaviva delle Fonti 70021Italy Department of Radiology IRCCS INRCAAncona 60126Italy

BACKGROUND gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed *** tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the *** To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic *** In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were ***-three(65.7%)patients underwent endoscopy before *** volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated *** rate was obtained from volume change between the two phases and standardised for unit *** were divided into two groups,according to the angiographic signs and their concordance with *** Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)*** no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

关键词： gastrointestinal haemorrhage Computed tomography angiography Volumetric analysis Computer-assisted image interpretation Therapeutic embolization Transcatheter arterial embolization

Catheter-directed thrombolysis in inflammatory bowel diseases:Report of a case

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World Journal of Gastroenterology 2012年第34期18卷 4791-4793页

作者： Péter Ilonczai Judit Tóth László Tóth István Altorjay Zoltán Boda Károly Palatka Division of Haemostasis 2nd Department of MedicineMedical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary Euromedic Diagnostics Hungary Ltd. Medical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary Department of Pathology Medical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary Division of Gastroenterology 2nd Department of MedicineMedical and Health Science CentreUniversity of Debrecen4032 DebrecenHungary

In patients with inflammatory bowel diseases (IBD) the prevalence of thrombosis is 6.2%, the average incidence of thromboembolism (TE) is 3.6 times higher compared to normal population. The TE is a common extraintestinal complication of IBD, squarely associated with the IBD activity. The application of antico-agulant and thrombolytic therapy in severe IBD is an unresolved issue. Herein we report the first case in literature of an active IBD patient with an upper limb acute arterial occlusion and successful catheter-directed thrombolysis (CDT). A 46-year-old male patient is reported who had Crohn's disease for 10 years. His right hand suddenly became cold and painful. Angiography proved acute occlusion of the brachial and radial artery. Vascular surgery intervention was not applicable. Endoscopy showed extended, severe inflammation of the colon. Despite the severe endoscopic findings, frequent bloody stools and moderate anaemia, CDT with recombinant tissue plasminogen activator was performed. The control angiography proved improvement, the radial artery pulse appeared. No bleeding complication was observed. This case supports that CDT-after careful estimation of the bleeding risk-can be effective and safe in patients with severe or life-threatening TE and active IBD.

关键词： Inflammatory bowel disease Crohn's dis-ease Thromboembolism Catheter-directed thromboly-sis gastrointestinal haemorrhage

Endoscopic treatment of primary aorto-enteric fistulas:A case report and review of literature

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World Journal of gastrointestinal Endoscopy 2021年第6期13卷 189-197页

作者： Victoria Berner-Hansen August A Olsen Birgitte Brandstrup Department of Surgery Holbaek HospitalPart of Copenhagen University HospitalsHolbaek 4300Denmark Institute for Clinical Medicine University of CopenhagenCopenhagen 2200Denmark Faculty of Health and Medical Sciences University of CopenhagenCopenhagen 2200Denmark

BACKGROUND Primary aorto-enteric fistula(PAEF)is a rare condition,traditionally treated in the acute,bleeding phase with open surgery or endovascular ***,these approaches have high morbidity and mortality,indicating a need for new *** advances in endoscopic techniques and equipment,haemoclipping of fistulas has now become ***,we present a systematic review of the English literature and a rare case of a PAEF successfully treated by endoscopic *** SUMMARY A 74-year-old man with an abdominal aortic aneurysm presented with symptoms of haemorrhagic shock and bloody *** oesophago-gastro-duodenoscopy was performed with haemoclipping of a suspected PAEF in the third part of the ***,a computed tomography-angiography showed a contrast filled protrusion from the abdominal aortic *** on the clinical presentation and the combined endoscopic and radiographic findings,we argue that this is a case of a *** Endoscopic therapy appears capable of achieving haemodynamic stabilisation in patients with bleeding PAEF,serving as a bridge to final therapy.

关键词： Endoscopy gastrointestinal haemorrhage Surgical clip Intestinal fistula,Vascular fistula Systematic review Case report