{"title":"Stemming the tide of chronic kidney disease: A focus on primary care prevention.","authors":"Sally Chih Wei Ho, Andrew Teck Wee Ang, Alvin Ren Kwang Tng","doi":"10.47102/annals-acadmedsg.2024291","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024291","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"591-593"},"PeriodicalIF":2.5,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.47102/annals-acadmedsg.2024220
Yan Sun, Lixia Ge, Yee Gary Ang, Zhiwen Joseph Lo, Huiling Liew, Donna Ml Tan, Daniel Chew, John Arputhan Abisheganaden
{"title":"Cost-effectiveness and clinical outcomes of artificial intelligence-enhanced screening for diabetic foot ulcers: A simulation study.","authors":"Yan Sun, Lixia Ge, Yee Gary Ang, Zhiwen Joseph Lo, Huiling Liew, Donna Ml Tan, Daniel Chew, John Arputhan Abisheganaden","doi":"10.47102/annals-acadmedsg.2024220","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024220","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"638-640"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.47102/annals-acadmedsg.2024301
Deshawn Chong Xuan Tan, Ken Cheah Hooi Lee
{"title":"Journey towards a smoke-free nation.","authors":"Deshawn Chong Xuan Tan, Ken Cheah Hooi Lee","doi":"10.47102/annals-acadmedsg.2024301","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024301","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"594-596"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.47102/annals-acadmedsg.2024146
Krystal Koh, Manisha Mathur, Rajeswari Kathirvel
{"title":"Serum progesterone in the management of pregnancy of unknown location: A Singapore experience.","authors":"Krystal Koh, Manisha Mathur, Rajeswari Kathirvel","doi":"10.47102/annals-acadmedsg.2024146","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024146","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"632-634"},"PeriodicalIF":2.5,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.47102/annals-acadmedsg.2023399
Sky Wei Chee Koh, Ping Young Ang, Hung Chew Wong, Hui Qi Koh, Nurfaziela Binti Zainal, Cynthia Sze Mun Wong
Introduction: Holistic Approach in Lowering and Tracking Chronic Kidney Disease (HALT-CKD) is a nationwide programme that was introduced in 2017 to combat CKD in Singapore. This study aims to evaluate outcomes of the HALT-CKD programme and identify factors influencing disease progression among early CKD patients.
Method: We conducted a retrospective cohort study involving adult patients aged 21 to 80 with CKD stages G1-G3A, recruited from 5 Singapore polyclinics between 2017 and 2018. The primary outcome-time to progression to advanced CKD (G3B-G5)-was tracked until March 2023, based on patients' last known serum creatinine levels. Descriptive statistics and Cox regression were used. Patients who followed up with other institutions, were deceased or defaulted without developing (or experiencing) the outcome were censored.
Results: We studied 3800 patients (mean age: 61.9 years) for a median of 4.7 years. Among them, 12.6% developed advanced CKD despite statistically significant improvements in HbA1c, blood pressure and albuminuria levels. Increasing age, female sex, clinic, baseline creatinine, diastolic blood pressure and HbA1c significantly shortened time to CKD progression. Macro-albuminuria at baseline (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.19- 2.61) and at analysis (HR 2.22, 95% CI 1.55-3.19) significantly accelerated advanced CKD progression. Patients who had their angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB) dose reduced or discontinued progressed to advanced CKD earlier (HR 1.92, 95% CI 1.50-2.45). Counselling and sodium-glucose cotransporter-2 inhibitor (SGLT2i) use did not significantly delay CKD progression.
Conclusion: Maintaining optimal ACEi/ARB dosage is essential to delay CKD progression. Premature cessation or reduction of this dosage should be discouraged. Further research on counselling and SGLT2i use in early CKD is needed to address the growing burden of CKD.
{"title":"Five-year outcomes of a holistic programme for managing early chronic kidney disease in primary care.","authors":"Sky Wei Chee Koh, Ping Young Ang, Hung Chew Wong, Hui Qi Koh, Nurfaziela Binti Zainal, Cynthia Sze Mun Wong","doi":"10.47102/annals-acadmedsg.2023399","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023399","url":null,"abstract":"<p><strong>Introduction: </strong>Holistic Approach in Lowering and Tracking Chronic Kidney Disease (HALT-CKD) is a nationwide programme that was introduced in 2017 to combat CKD in Singapore. This study aims to evaluate outcomes of the HALT-CKD programme and identify factors influencing disease progression among early CKD patients.</p><p><strong>Method: </strong>We conducted a retrospective cohort study involving adult patients aged 21 to 80 with CKD stages G1-G3A, recruited from 5 Singapore polyclinics between 2017 and 2018. The primary outcome-time to progression to advanced CKD (G3B-G5)-was tracked until March 2023, based on patients' last known serum creatinine levels. Descriptive statistics and Cox regression were used. Patients who followed up with other institutions, were deceased or defaulted without developing (or experiencing) the outcome were censored.</p><p><strong>Results: </strong>We studied 3800 patients (mean age: 61.9 years) for a median of 4.7 years. Among them, 12.6% developed advanced CKD despite statistically significant improvements in HbA1c, blood pressure and albuminuria levels. Increasing age, female sex, clinic, baseline creatinine, diastolic blood pressure and HbA1c significantly shortened time to CKD progression. Macro-albuminuria at baseline (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.19- 2.61) and at analysis (HR 2.22, 95% CI 1.55-3.19) significantly accelerated advanced CKD progression. Patients who had their angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB) dose reduced or discontinued progressed to advanced CKD earlier (HR 1.92, 95% CI 1.50-2.45). Counselling and sodium-glucose cotransporter-2 inhibitor (SGLT2i) use did not significantly delay CKD progression.</p><p><strong>Conclusion: </strong>Maintaining optimal ACEi/ARB dosage is essential to delay CKD progression. Premature cessation or reduction of this dosage should be discouraged. Further research on counselling and SGLT2i use in early CKD is needed to address the growing burden of CKD.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"597-607"},"PeriodicalIF":2.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.47102/annals-acadmedsg.2024177
Yen Sin Koh, Rajeswari Sambasivam, P V AshaRani, Edimansyah Abdin, Saleha Shafie, Stefan Ma, Wai Leng Chow, Siow Ann Chong, Yvette van der Eijk, Mythily Subramaniam
Introduction: Singapore has implemented an evidence-based smoking cessation framework to support smokers in quitting. Our study investigated the prevalence and correlates of (1) quit attempts (QA) and quit intentions (QI) among current smokers, and (2) smoking cessation (SC) among ever-smokers in Singapore.
Method: Data was collected from a nationwide survey conducted between 2020 and 2022. QA was defined as attempting to stop smoking at least once in the past 12 months, while QI was defined as planning to quit smoking within the next 30 days or the next 6 months. SC referred to individuals who quit smoking over 6 months ago. Sociodemographic factors, doctor's advice to quit and perceived harm from smoking were assessed using logistic regression among current smokers (n=1024) and ever-smokers (n=1457).
Results: Among current smokers, 31.3% and 41.2% reported QI and QA, respectively. Smokers with secondary or pre-tertiary education were less likely to report QI compared to those with a degree or higher. Doctor's advice to quit was associated with a higher likelihood of QA. Among ever-smokers, 25.3% reported SC, and this was more likely when they perceived smoking 1 or more packs of cigarettes daily as posing a moderate or high health risk.
Conclusion: Educational campaigns should focus on simplifying messages for individuals with lower literacy levels. Smoking cessation training can be incorporated into medical education, and graphic health warnings on cigarette packs can help effectively communicate the dangers of smoking.
{"title":"Factors influencing smoking cessation: Insights from Singapore's nationwide health and lifestyle survey.","authors":"Yen Sin Koh, Rajeswari Sambasivam, P V AshaRani, Edimansyah Abdin, Saleha Shafie, Stefan Ma, Wai Leng Chow, Siow Ann Chong, Yvette van der Eijk, Mythily Subramaniam","doi":"10.47102/annals-acadmedsg.2024177","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024177","url":null,"abstract":"<p><strong>Introduction: </strong>Singapore has implemented an evidence-based smoking cessation framework to support smokers in quitting. Our study investigated the prevalence and correlates of (1) quit attempts (QA) and quit intentions (QI) among current smokers, and (2) smoking cessation (SC) among ever-smokers in Singapore.</p><p><strong>Method: </strong>Data was collected from a nationwide survey conducted between 2020 and 2022. QA was defined as attempting to stop smoking at least once in the past 12 months, while QI was defined as planning to quit smoking within the next 30 days or the next 6 months. SC referred to individuals who quit smoking over 6 months ago. Sociodemographic factors, doctor's advice to quit and perceived harm from smoking were assessed using logistic regression among current smokers (n=1024) and ever-smokers (n=1457).</p><p><strong>Results: </strong>Among current smokers, 31.3% and 41.2% reported QI and QA, respectively. Smokers with secondary or pre-tertiary education were less likely to report QI compared to those with a degree or higher. Doctor's advice to quit was associated with a higher likelihood of QA. Among ever-smokers, 25.3% reported SC, and this was more likely when they perceived smoking 1 or more packs of cigarettes daily as posing a moderate or high health risk.</p><p><strong>Conclusion: </strong>Educational campaigns should focus on simplifying messages for individuals with lower literacy levels. Smoking cessation training can be incorporated into medical education, and graphic health warnings on cigarette packs can help effectively communicate the dangers of smoking.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"608-620"},"PeriodicalIF":2.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.47102/annals-acadmedsg.2024223
Jack Choo, Jonathan Yap, Aidila Ismail, Jin Shing Hon, Wen Ruan, Andrea Low, Soo Teik Lim, Ju Le Tan
{"title":"Intravenous epoprostenol therapy in the treatment of pulmonary arterial hypertension in Singapore.","authors":"Jack Choo, Jonathan Yap, Aidila Ismail, Jin Shing Hon, Wen Ruan, Andrea Low, Soo Teik Lim, Ju Le Tan","doi":"10.47102/annals-acadmedsg.2024223","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2024223","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"627-631"},"PeriodicalIF":2.5,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-07DOI: 10.47102/annals-acadmedsg.2023300
Xi Zhen Low, Mohammad Shaheryar Furqan, Andrew Makmur, Desmond Shi Wei Lim, Ren Wei Liu, Xinyi Lim, Yiong Huak Chan, Jiong Hao Tan, Leok Lim Lau, James Thomas Patrick Decourcy Hallinan
{"title":"Automated Cobb angle measurement in scoliosis radiographs: A deep learning approach for screening.","authors":"Xi Zhen Low, Mohammad Shaheryar Furqan, Andrew Makmur, Desmond Shi Wei Lim, Ren Wei Liu, Xinyi Lim, Yiong Huak Chan, Jiong Hao Tan, Leok Lim Lau, James Thomas Patrick Decourcy Hallinan","doi":"10.47102/annals-acadmedsg.2023300","DOIUrl":"https://doi.org/10.47102/annals-acadmedsg.2023300","url":null,"abstract":"","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"635-637"},"PeriodicalIF":2.5,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-03DOI: 10.47102/annals-acadmedsg.2024141
Mei Leng Chan, Dwee Wee Lim, Khin Khin Win, Helen Smith
Introduction: The global incidence of dementia is increasing, and cognitively impaired drivers are at a higher risk of crashes compared to healthy drivers. Doctors face challenges in assessing these at-risk drivers, with questionable adherence to existing guidelines. This study aimed to review and compare guidelines for managing cognitively impaired drivers from various countries.
Method: A scoping review was conducted to identify relevant guidelines, which were then descriptively compared with Singapore's guideline.
Results: Eleven guidelines from 8 countries: US (n=2), Canada (n=2), UK (n=2), Ireland, Belgium, Australia, New Zealand and Singapore were reviewed. All guidelines support driving assessments and conditional licensing in ordinary (i.e. non-professional) drivers with dementia. Canada stands out for not allowing co-piloting and geographical restrictions in conditional licensing practice. Few guidelines provide indemnity for doctors reporting to licensing authorities, and communication about the impact of dementia on car insurance is rarely addressed. Most Western guidelines include evidence-based approaches, provisions for drivers with mild cognitive impairment and early discussions on transitioning from driving. A clinic-based functional screening toolbox and 2 clinical algorithms (1 with and 1 without the Clinical Dementia Rating scale) were identified as having universal applicability. Singapore's guideline, by comparison, is outdated and lacks both developmental rigour and guidance on managing mild cognitive impairment and transitioning drivers out of driving.
Conclusion: Comprehensive, evidence-based guidelines from Western countries provide valuable resources that can help Singapore design or update its guideline.
{"title":"Enhancing guidelines for managing cognitively impaired drivers: Insights from Western evidence for Asian adaptation.","authors":"Mei Leng Chan, Dwee Wee Lim, Khin Khin Win, Helen Smith","doi":"10.47102/annals-acadmedsg.2024141","DOIUrl":"10.47102/annals-acadmedsg.2024141","url":null,"abstract":"<p><strong>Introduction: </strong>The global incidence of dementia is increasing, and cognitively impaired drivers are at a higher risk of crashes compared to healthy drivers. Doctors face challenges in assessing these at-risk drivers, with questionable adherence to existing guidelines. This study aimed to review and compare guidelines for managing cognitively impaired drivers from various countries.</p><p><strong>Method: </strong>A scoping review was conducted to identify relevant guidelines, which were then descriptively compared with Singapore's guideline.</p><p><strong>Results: </strong>Eleven guidelines from 8 countries: US (n=2), Canada (n=2), UK (n=2), Ireland, Belgium, Australia, New Zealand and Singapore were reviewed. All guidelines support driving assessments and conditional licensing in ordinary (i.e. non-professional) drivers with dementia. Canada stands out for not allowing co-piloting and geographical restrictions in conditional licensing practice. Few guidelines provide indemnity for doctors reporting to licensing authorities, and communication about the impact of dementia on car insurance is rarely addressed. Most Western guidelines include evidence-based approaches, provisions for drivers with mild cognitive impairment and early discussions on transitioning from driving. A clinic-based functional screening toolbox and 2 clinical algorithms (1 with and 1 without the Clinical Dementia Rating scale) were identified as having universal applicability. Singapore's guideline, by comparison, is outdated and lacks both developmental rigour and guidance on managing mild cognitive impairment and transitioning drivers out of driving.</p><p><strong>Conclusion: </strong>Comprehensive, evidence-based guidelines from Western countries provide valuable resources that can help Singapore design or update its guideline.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 10","pages":"621-626"},"PeriodicalIF":2.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.47102/annals-acadmedsg.2023257
Amadora Choo, Eugene Lim, Alvin Eng, Weng Hoong Chan, Ravishankar Asokkumar, Jeremy Tan, Ai Shan Tan, Agnes Chong, Yumni Binte Md Shahrin, Xuan Wang, Phong Ching Lee, Chin Hong Lim
Introduction: Intolerance frequently limits the use of intragastric balloons (IGBs) in the treatment of obesity. This includes refractory nausea, vomiting and abdominal discomfort. Our study aims to identify predictors of balloon intolerance and early removal, which will help to guide patient selection for this intervention and peri-procedure care.
Method: We conducted a retrospective cohort study of 54 consecutive patients who underwent IGB insertion from July 2017 to July 2022 in a single tertiary institution in Singapore. Forty-seven (87.0%) patients completed therapy, while 7 patients (13.0%) had early removal of the balloon due to intolerance. Characteristics of both groups were compared.
Results: Multivariate analysis revealed significant associations between early balloon removal and both depression (P=0.012) and anxiety (P=0.001) after adjusting for age, sex, ethnicity, height, nulliparity, balloon type and volume. Univariate analysis revealed that anxiety was the main risk factor (P=0.004, odds ratio 9.111, 95% confidence interval 1.624-51.124), while depression was no longer a significant predictor.
Conclusion: Identifying predictors of balloon intolerance and early removal can enhance patient selection and improve peri-procedural care. In patients with a history of depression or anxiety, it is important to ensure adequate counselling and preparation prior to balloon insertion.
{"title":"Predictors of early removal of intragastric balloon due to intolerance: Insights from a multiethnic Asian cohort.","authors":"Amadora Choo, Eugene Lim, Alvin Eng, Weng Hoong Chan, Ravishankar Asokkumar, Jeremy Tan, Ai Shan Tan, Agnes Chong, Yumni Binte Md Shahrin, Xuan Wang, Phong Ching Lee, Chin Hong Lim","doi":"10.47102/annals-acadmedsg.2023257","DOIUrl":"10.47102/annals-acadmedsg.2023257","url":null,"abstract":"<p><strong>Introduction: </strong>Intolerance frequently limits the use of intragastric balloons (IGBs) in the treatment of obesity. This includes refractory nausea, vomiting and abdominal discomfort. Our study aims to identify predictors of balloon intolerance and early removal, which will help to guide patient selection for this intervention and peri-procedure care.</p><p><strong>Method: </strong>We conducted a retrospective cohort study of 54 consecutive patients who underwent IGB insertion from July 2017 to July 2022 in a single tertiary institution in Singapore. Forty-seven (87.0%) patients completed therapy, while 7 patients (13.0%) had early removal of the balloon due to intolerance. Characteristics of both groups were compared.</p><p><strong>Results: </strong>Multivariate analysis revealed significant associations between early balloon removal and both depression (P=0.012) and anxiety (P=0.001) after adjusting for age, sex, ethnicity, height, nulliparity, balloon type and volume. Univariate analysis revealed that anxiety was the main risk factor (P=0.004, odds ratio 9.111, 95% confidence interval 1.624-51.124), while depression was no longer a significant predictor.</p><p><strong>Conclusion: </strong>Identifying predictors of balloon intolerance and early removal can enhance patient selection and improve peri-procedural care. In patients with a history of depression or anxiety, it is important to ensure adequate counselling and preparation prior to balloon insertion.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"53 9","pages":"551-561"},"PeriodicalIF":2.5,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}