Clinical Outcomes and Complications for Achalasia Patients Admitted After Per-Oral Endoscopic Myotomy.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research Pub Date : 2023-06-01 DOI:10.14740/gr1617
Dushyant Singh Dahiya, Fnu Nivedita, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Manesh Kumar Gangwani, Muhammad Aziz, Hassam Ali, Chin-I Cheng, Madhusudhan R Sanaka, Mohammad Al-Haddad, Neil R Sharma
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Abstract

Background: Per-oral endoscopic myotomy (POEM) is a rapidly emerging minimally invasive procedure for management of achalasia. Same-day discharge after POEM is safe and feasible; however, some patients may need hospitalization. We aimed to identify characteristics and outcomes for achalasia patients requiring hospitalizations after POEM in the United States (US).

Methods: The US National Inpatient Sample was utilized to identify all adult achalasia patients who were admitted after POEM from 2016 to 2019. Hospitalization characteristics and clinical outcomes were highlighted.

Results: From 2016 to 2019, we found that 1,885 achalasia patients were admitted after POEM. There was an increase in the total number of hospitalizations after POEM from 380 in 2016 to 490 in 2019. The mean age increased from 54.2 years in 2016 to 59.3 years in 2019. Most POEM-related hospitalizations were for the 65 - 79 age group (31.8%), females (50.4%), and Whites (68.4%). A majority (56.2%) of the study population had a Charlson Comorbidity Index of 0. The Northeast hospital region had the highest number of POEM-related hospitalizations. Most of these patients (88.3%) were eventually discharged home. There was no inpatient mortality. The mean length of stay decreased from 4 days in 2016 to 3.2 days in 2019, while the mean total healthcare charge increased from $52,057 in 2016 to $65,109 in 2019. Esophageal perforation was the most common complication seen in 1.3% of patients.

Conclusion: The number of achalasia patients needing hospitalization after POEM increased. There was no inpatient mortality conferring an excellent safety profile of this procedure.

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经口内窥镜下肌切开术后贲门失弛缓症患者的临床结局及并发症。
背景:经口内窥镜下肌切开术(POEM)是一种快速兴起的治疗贲门失弛缓症的微创手术。POEM后当日排放安全可行;然而,有些病人可能需要住院治疗。我们的目的是确定在美国(US) POEM后需要住院治疗的失弛缓症患者的特征和结果。方法:采用美国国家住院患者样本对2016年至2019年POEM后入院的所有成年贲门失弛缓症患者进行鉴定。强调住院特点和临床结果。结果:2016年至2019年,我们发现1885例失弛缓症患者经POEM后入院。POEM后住院总人数从2016年的380人增加到2019年的490人。平均年龄从2016年的54.2岁增加到2019年的59.3岁。大多数与诗歌相关的住院患者为65 - 79岁年龄组(31.8%)、女性(50.4%)和白人(68.4%)。大多数(56.2%)研究人群的Charlson合并症指数为0。东北医院区与诗歌相关的住院人数最多。大多数患者(88.3%)最终出院回家。没有住院病人死亡。平均住院时间从2016年的4天减少到2019年的3.2天,而平均总医疗费用从2016年的52,057美元增加到2019年的65,109美元。食管穿孔是最常见的并发症,占1.3%。结论:POEM术后贲门失弛缓症患者住院人数增加。没有住院病人死亡率,这表明该手术具有良好的安全性。
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Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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