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首页> 美国卫生研究院文献>World Journal of Gastroenterology >Epidemiology of perforated peptic ulcer: Age- and gender-adjusted analysis of incidence and mortality
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Epidemiology of perforated peptic ulcer: Age- and gender-adjusted analysis of incidence and mortality

机译：穿孔性消化性溃疡的流行病学：年龄和性别调整后的发病率和死亡率分析

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AIM: To investigate the epidemiological trends in incidence and mortality of perforated peptic ulcer (PPU) in a well-defined Norwegian population.METHODS: A retrospective, population-based, single-center, consecutive cohort study of all patients diagnosed with benign perforated peptic ulcer. Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010. Ulcers with a malignant neoplasia diagnosis, verified by histology after biopsy or resection, were excluded. Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes (K25.1, K25.2, K25.5, K25.6, K26.1, K26.2, K26.5, K26.6). Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures (e.g., JDA 60, JDA 61, JDH 70 and JDH 71) were performed to enable a complete identification of all patients. Patient demographics, presentation patterns and clinical data were retrieved from hospital records and surgical notes. Crude and adjusted incidence and mortality rates were estimated by using national population demographics data.RESULTS: In the study period, a total of 172 patients with PPU were identified. The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year (95%CI: 5.6-7.6) and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year (95%CI: 0.7-1.6). A non-significant decline in adjusted incidence rate from 9.7 to 5.6 occurred during the decade. The standardized mortality ratio for the whole study period was 5.7 (95%CI: 3.9-8.2), while the total 30-d mortality was 16.3%. No difference in incidence or mortality was found between genders. However, for patients ≥ 60 years, the incidence increased over 10-fold, and mortality more than 50-fold, compared to younger ages. The admission rates outside office hours were high with almost two out of three (63%) admissions seen at eveningight time shifts and/or during weekends. The observed seasonal variations in admissions were not statistically significant.CONCLUSION: The adjusted incidence rate, seasonal distribution and mortality rate was stable. PPU frequently presents outside regular work-hours. Increase in incidence and mortality occurs with older age.
机译：目的：调查在明确界定的挪威人群中穿孔性消化性溃疡（PPU）的发病率和死亡率的流行病学趋势。方法：对所有诊断为良性穿孔性消化性溃疡的患者进行回顾性，基于人群的单中心连续队列研究溃疡。包括2001年1月至2010年12月在斯塔万格大学医院就诊的胃溃疡和十二指肠溃疡患者。经活检或切除后经组织学证实为恶性肿瘤的溃疡被排除在外。使用相关的ICD-9和ICD-10代码（K25.1，K25.2，K25.5，K25.6，K26.1，K26.2，K26.5，K26）从医院行政电子数据库中识别出患者。 6）。使用适当的代码对相关的腹腔镜手术和开放性手术程序（例如JDA 60，JDA 61，JDH 70和JDH 71）进行了进一步搜索，以全面识别所有患者。从医院记录和手术记录中检索患者的人口统计资料，表现形式和临床数据。粗略的和调整后的发病率和死亡率通过使用全国人口统计学数据进行估算。结果：在研究期间，共确定了172例PPU患者。整个10年期间的调整后发病率是每年每100 000 6.5（95％CI：5.6-7.6），而整个10年期间的调整后死亡率是每年每100 000（1.1％）（95％CI ：0.7-1.6）。在过去的十年中，调整后的发病率从9.7下降到5.6，无明显下降。整个研究期间的标准死亡率为5.7（95％CI：3.9-8.2），而30天总死亡率为16.3％。性别之间的发病率或死亡率没有差异。但是，对于≥60岁的患者，与年轻年龄相比，其发病率增加了10倍以上，死亡率超过了50倍。办公时间以外的入学率很高，几乎有三分之二（63％）的入学时间是在晚上/晚上的班次和/或周末。结论：经调整的发病率，季节性分布和死亡率均保持稳定。 PPU经常在正常工作时间以外出现。发病率和死亡率随着年龄的增长而增加。

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