• 作者：Francisco José ; Mart&#237 ; nez Cerezo^a ; ^{fjmartinez@grupsagessa.com} ; Ghassan Mreish Tatros^b ; Francisco Vida Mombiela^c ; Albert Tomas^d ; Á ; gueda Abad^d ; Rafael Campo^d ; Joan Saló ; ^d ; Jaume Boadas^d ; Fernando Bañ ; os^d ; Joaquim Rigau^d ; Miriam Sabat^d ; Silvia Fà ; bregas^d ; Lluis Vidal^d ; Montserrat Planella^d ; Josep Maria Castellv&#237 ; ^d ; Josep Giné ; ^d ; Esteban Saperas^d ; Sandra Torra^d ; Antonio J. Creix^d ; Miquel Torres^d ; Jordi Rey^d ; Virginia Garc&#237 ; a^d ; José ; Carlos Laguna^d ; Domingo Pascual^a ; Cristina Manso^d
• 关键词：Hemorragia gastrointestinal ; Ú ; lcera pé ; ptica ; Hemorragia ; Hemostasia ; endoscopia/mé ; todos ; Varices esofá ; gicas y gá ; stricas ; Tratamiento ; Inhibidores de la bomba de protones/uso terapé ; utico ; Agentes vasoconstrictores
• 刊名：Gastroenterolog¨ªa y Hepatolog¨ªa
• 出版年：2011
• 出版时间：November 2011
• 年：2011
• 卷：34
• 期：9
• 页码：605-610
• 全文大小：122 K

Objective

To evaluate the resources available in Catalan regional hospitals for the emergency care of upper gastrointestinal hemorrhage.

Methods

We analyzed a survey sent to 32 hospitals on the availability, composition and resources of a duty endoscopy service for the year 2009.

Results

Responses were obtained from 24 centers, covering 3,954,000 inhabitants. Duty endoscopists were available in 12 hospitals. A total of 1,483,000 inhabitants were unable to access a duty endoscopist in the referral center. Centers with duty endoscopists had more beds and had a larger catchment area. Duty services were composed of 4.5 endoscopists (range 2-11), covering 82.1 (33.2-182.5) duty shifts/year. Seventeen centers reported 1,571 episodes (51 % , range: 3-280, 39.68/100,000 inhabitants). Centers with a duty service reported a greater number of cases (76 vs. 43, p = 0.047). Centers without this service referred a greater number of patients (147 vs. 17, p = 0.001). Patients in the emergency department were under the care of the internal medicine department in four centers, the surgery department in 14 centers and under the care of both departments in six. Admitted patients were under the care of the gastroenterology department in only six hospitals. The most widely used procedures were ligation of varicose bleeding and injection therapies in non-varicose bleeding. Twenty-one percent of centers did not perform combined treatment.

Conclusions

A significant proportion of the population does not have access to a duty endoscopist in referral centers. Duty shifts represent significant workload in regional hospitals. Coordination among health professionals and centers would allow the efficient application of therapeutic resources and a duty endoscopy service to be established in centers lacking this resource.