摘要

急性消化性溃疡出血与大量的短期死亡率有关，但一般认为，在现代有效的医学治疗中，长期预后良好。本研究评估了1986-91年间因急性消化性溃疡出血从诺丁汉大学和城市医院出院的487例60岁以上患者和480例年龄和性别匹配的社区对照。从医院和全科医生记录以及国家卫生服务中心登记册中获得了后续信息。死亡率与对照死亡率以及英格兰和威尔士的预期死亡率进行了比较。在平均34个月的随访期间，487例患者中有142例(29%)死亡，而480例社区对照中有58例(12%)死亡，预计死亡81.5例(观察/预期(O/E) = 1.74, 95%置信限(CL) 1.5至2.1)。入院6年后，溃疡患者的精算生存率仅为50%，而社区对照组为76%，预期生存率为69%。死亡率的增加在男性和女性中相似，在60-74岁年龄组中最大。大部分超额死亡率是由癌症死亡造成的(O/E 34/19.7 = 1.73;CL 1.2至2.4)，呼吸系统疾病(O/E 28/10.9 = 2.57;CL为1.7 - 3.7)，男性血管疾病患者(O/E 31/22.4 = 1.38; CL 0.9 to 2.0). Eight deaths resulted from recurrent ulcer complications and four deaths from gastric cancers undetected at the index admission. In conclusion, patients discharged after peptic ulcer bleeding had a substantially reduced life expectancy. The increased mortality was predominantly due to a variety of smoking related diseases rather than recurrent peptic ulcer complications. Deaths from recurrent peptic ulcer complications were infrequent and were less than reported in earlier years possibly reflecting prolonged and widespread used of H2 receptor antagonists.