Analysis of the impact of emergency treatment channel on the curative effect of patients with upper gastrointestinal bleeding based on the inverse probability of treatment weighting
10.3969/j.issn.1008-9691.2024.02.015
- VernacularTitle:基于逆概率加权法分析急诊救治通道对上消化道出血患者治疗效果的影响
- Author:
Weifeng GOU
1
;
Xiaoqian ZHOU
;
Die DENG
;
Jingbin JIANG
Author Information
1. 贵州医科大学临床医学院,贵州贵阳 550004
- Keywords:
Emergency rescue channel;
Glasgow-Blatchford score;
Inverse probability of treatment weighting;
Treatment effect
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(2):203-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical effectiveness of emergency upper gastrointestinal bleeding channel for patients with acute upper gastrointestinal bleeding(AUGIB)by the inverse probability of treatment weighted(IPTW)method.Methods A retrospective study method was used.The clinical information was collected on 299 AUGIB patients who belonged to the First People's Hospital of Guiyang,where they were admitted from January 2018 to December 2021.AUGIB patients admitted before the establishment of emergency treatment channel(from January 2018 to December 2019)were selected as the routinel group(152 cases),while AUGIB patients admitted after the establishment of emergency treatment channel(from January 2020 to December 2021)were selected as the channel group(147 cases).IPTW was used to balance multiple confounding variables[gender,age,history of previous underlying diseases,history of non-steroidal anti-inflammatory drug(NSAID)administration,personal history,Glasgow-Blatchford score(GBS),different bleeding etiologies,etc.],a consistent distribution of confounding variables among the groups was achieved after IPTW treatment.The difference of clinical treatment effects between the routine group and the channel group was performed,including time to hemostasis,recurrent bleeding rate,volume of blood transfusions,length of hospital stay,hospitalization cost,intensive care unit(ICU)transfer rate,and mortality etc.were compared.Results After IPTW,the confounding variables were well-balanced between groups.The time to hemostasis[hours:7.90(5.36,11.42)vs.9.92(6.25,18.15)],recurrent bleeding rate[23.1%(34/147)vs.40.1%(61/152)],length of hospital stay[days:8.00(7.00,10.34)vs.9.00(7.00,13.00)],ICU transfer rate[8.8%(13/147)vs.17.7%(27/152)],and mortality[0.7%(1/147)vs.4.5%(7/152)]in channel group were significantly lower than those in the routine group(all P<0.05).There were no significant difference in transfusions volume and hospital cost between channel group and routine group[transfusions volume(U):2(0,4)vs.2(0,4),hospitalization cost(ten thousand yuan):1.35(1.03,2.00)vs.1.16(0.71,2.29),both P>0.05].Conclusion The emergency treatment channel can reduce the recurrent bleeding rate,ICU transfer rate,and mortality rate,shorten the time of hemostasis and length of hospital stay,and has a good treatment effect.
