{"title":"Selective pathological and therapeutic potential of the cell cycle pathway in hepatitis B virus-related hepatocellular carcinoma","authors":"Chen Lu, M. Xiao, Xiaodong Li","doi":"10.12032/GHR2020-03-011","DOIUrl":"https://doi.org/10.12032/GHR2020-03-011","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76461915","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}
{"title":"Investigating the Key Pathogenesis of Malignant Transformation of Precancerous Changes in the Liver Based on the Theory “Liver Governs Growth”","authors":"Jingtao Li, Yonggang Liu, Hai-liang Wei, Shu-guang Yan, Qian Li, Di Ju, Ying-Gun Guo, Chang Zhanjie","doi":"10.12032/GHR2020-03-009","DOIUrl":"https://doi.org/10.12032/GHR2020-03-009","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75212840","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}
{"title":"Role of apoptosis in the pathogenesis of primary biliary cholangitis","authors":"Bukun Zhu, Wei Zhang","doi":"10.12032/GHR2020-03-007","DOIUrl":"https://doi.org/10.12032/GHR2020-03-007","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"159 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75264109","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}
{"title":"Investigation on Hepatitis B Virus infection in a four-generation family in China","authors":"Fengxia Sun, Xiao-ling Li, M. Luo","doi":"10.12032/GHR2020-03-010","DOIUrl":"https://doi.org/10.12032/GHR2020-03-010","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74091167","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 : 2020-02-21DOI: 10.17554/J.ISSN.2224-3992.2020.09.869
Daniyan Olapeju W, Ibe Chidozie B, Ezeonu Thecla C, Anyanwu Onyinye U, Ezeanosike Obumneme B, Omeje Kenneth N
Background: Helicobacter pylori is a common cause of infection among humans. The organism is usually acquired in childhood but may persist into adulthood resulting in chronic gastritis, peptic ulcer disease and adenocarcinoma. Aim: To determine the seroprevalence and risk factors of H. pylori infection among children seen at the Paediatric Out-Patient Clinic of a tertiary teaching hospital in South- East, Nigeria. Methods: It was a cross-sectional study carried out among 248 children aged between 1 and 18 years seen at the Paediatric Outpatient Clinic at the tertiary hospital from August 2017 to October 2017. Information on socio-demographics, feeding practices, daycare attendance and vaccination were obtained and entered into a proforma. The serum obtained from the patient was tested for H. pylori antibodies. Results: The seroprevalence of H. pylori infection among the subjects was 36.3%. Statistically significant association was found between age of the subjects, parental education, social class, ingestion of uncooked/ raw food materials and H. pylori infection (p < 0.05). On logistic regression analysis, predictors of H. pylori infection were age 6-12 years (AOR = 2.42, 95% CI = 1.31-4.47, p = 0.005) and ingestion of uncooked/raw food materials (AOR= 2.38, 95% CI 1.14-8.33, p = 0.022). Conclusion: Risk factors associated with H. pylori infection include age, parental education, social class and ingestion of uncooked or raw food materials.
{"title":"Seroprevalence and Risk Factors of Helicobacter Pylori Infection Among Children in South-East Nigeria","authors":"Daniyan Olapeju W, Ibe Chidozie B, Ezeonu Thecla C, Anyanwu Onyinye U, Ezeanosike Obumneme B, Omeje Kenneth N","doi":"10.17554/J.ISSN.2224-3992.2020.09.869","DOIUrl":"https://doi.org/10.17554/J.ISSN.2224-3992.2020.09.869","url":null,"abstract":"Background: Helicobacter pylori is a common cause of infection among humans. The organism is usually acquired in childhood but may persist into adulthood resulting in chronic gastritis, peptic ulcer disease and adenocarcinoma. Aim: To determine the seroprevalence and risk factors of H. pylori infection among children seen at the Paediatric Out-Patient Clinic of a tertiary teaching hospital in South- East, Nigeria. Methods: It was a cross-sectional study carried out among 248 children aged between 1 and 18 years seen at the Paediatric Outpatient Clinic at the tertiary hospital from August 2017 to October 2017. Information on socio-demographics, feeding practices, daycare attendance and vaccination were obtained and entered into a proforma. The serum obtained from the patient was tested for H. pylori antibodies. Results: The seroprevalence of H. pylori infection among the subjects was 36.3%. Statistically significant association was found between age of the subjects, parental education, social class, ingestion of uncooked/ raw food materials and H. pylori infection (p < 0.05). On logistic regression analysis, predictors of H. pylori infection were age 6-12 years (AOR = 2.42, 95% CI = 1.31-4.47, p = 0.005) and ingestion of uncooked/raw food materials (AOR= 2.38, 95% CI 1.14-8.33, p = 0.022). Conclusion: Risk factors associated with H. pylori infection include age, parental education, social class and ingestion of uncooked or raw food materials.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"9 1","pages":"3066-3070"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43469026","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 : 2020-02-21DOI: 10.17554/j.issn.2224-3992.2020.09.890
F. N. Franco, Marcos Augusto Nascimento Porto
Excess lipids stored in adipose tissue can lead to changes in metabolism. It is known that the treatment with Momordica charantia (MC) is able to stimulate lipolysis, decrease insulin resistance, triacylglycerol concentration and body weight. Thus, the aim of this study was to investigate the effect of MC tea administration to prevent biochemical changes in the metabolism of mice fed high fat diet. For this, swiss mice were fed with a control diet (C) or a high fat diet for 4 and 8 weeks (HF). They also received water or MC tea during treatment (CP, HFP). Body weight, food and water intake were evaluated daily. After treatment, the HF and HFP animals were submitted to the Glucose Tolerance Test. All groups were euthanized and blood was collected for analysis of biochemical parameters. The epididymal, retroperitoneal and liver tissues were weighed. hepatic tissue were also used to quantification of lipids. The results were analyzed using Student's T test (p<0.05) and expressed as mean ± SE. A progressive decrease in the accumulation of lipids in adipose tissues and in the liver, as well as in the serum levels of TAG and VLDL was observed between the HFP8 vs HFP4 groups The carbohydrate metabolism presented very expressive changes in a short time of treatment (HFP4). The data suggest that MC appears to be effective in preventing changes in metabolism, probably by preventing the increase of lipid deposits, decreasing the inflammatory process and leading to an improvement in insulin sensitivity.
{"title":"Effect of Momordica Charantia on The Prevention of Changes in Serum and Hepatic Metabolism of Animals Fed A High Fat Diet","authors":"F. N. Franco, Marcos Augusto Nascimento Porto","doi":"10.17554/j.issn.2224-3992.2020.09.890","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.890","url":null,"abstract":"Excess lipids stored in adipose tissue can lead to changes in metabolism. It is known that the treatment with Momordica charantia (MC) is able to stimulate lipolysis, decrease insulin resistance, triacylglycerol concentration and body weight. Thus, the aim of this study was to investigate the effect of MC tea administration to prevent biochemical changes in the metabolism of mice fed high fat diet. For this, swiss mice were fed with a control diet (C) or a high fat diet for 4 and 8 weeks (HF). They also received water or MC tea during treatment (CP, HFP). Body weight, food and water intake were evaluated daily. After treatment, the HF and HFP animals were submitted to the Glucose Tolerance Test. All groups were euthanized and blood was collected for analysis of biochemical parameters. The epididymal, retroperitoneal and liver tissues were weighed. hepatic tissue were also used to quantification of lipids. The results were analyzed using Student's T test (p<0.05) and expressed as mean ± SE. A progressive decrease in the accumulation of lipids in adipose tissues and in the liver, as well as in the serum levels of TAG and VLDL was observed between the HFP8 vs HFP4 groups The carbohydrate metabolism presented very expressive changes in a short time of treatment (HFP4). The data suggest that MC appears to be effective in preventing changes in metabolism, probably by preventing the increase of lipid deposits, decreasing the inflammatory process and leading to an improvement in insulin sensitivity.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"9 1","pages":"3082-3087"},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45028225","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 : 2020-02-21DOI: 10.17554/j.issn.2224-3992.2020.09.893
K. Koizumi, M. Hasegawa, Akira Mukaitani, A. Yagi
We present two case reports: beneficial roles of successive ingestion of aloe vera juice for medical treatment of steroid-sensitive nephrotic kidney syndrome in child.
我们提出了两个病例报告:连续摄入芦荟汁对儿童类固醇敏感性肾病肾病综合征医学治疗的有益作用。
{"title":"Case Reports: Beneficial Roles of Aloe vera Juice-successive Ingestion to Children with Steroid-Sensitive Nephrotic Syndrome","authors":"K. Koizumi, M. Hasegawa, Akira Mukaitani, A. Yagi","doi":"10.17554/j.issn.2224-3992.2020.09.893","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.893","url":null,"abstract":"We present two case reports: beneficial roles of successive ingestion of aloe vera juice for medical treatment of steroid-sensitive nephrotic kidney syndrome in child.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47927634","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 : 2020-02-21DOI: 10.17554/j.issn.2224-3992.2020.09.888
M. Hassan, Soha Saoud Abd El Monem, A. Hasanain, Rasha Hosny Sayed, Amal Aziz
Background& aim: HCV infection is one of the major health problems in our country. Prevalence of DM is higher among patients with chronic HCV infection. Insulin resistance (IR) is common in such and its impact on sustained virological response (SVR) is not well studied. This work was designed to assess impact of IR on SVR. Patients & methods: Between July 2016 and June 2017; 200 patients with chronic HCV infection were enrolled in a prospective study. Exclusion criteria included decompensated cirrhosis, hepatocellular carcinoma or extrahepatic malignancy, co-infection with HBV or HIV infection. HOMA and IR were assessed at baseline of therapy and 3-months post-therapy. Patients received sofosbuvir and daclatasvir for 3 months (chronic hepatitis) and for 6 months in (liver cirrhosis). Results: Mean age of patients was 49.89 ± 9.01 years, 111 (55.5%) patients were male and 180 (90%) achieved SVR. Baseline IR had insignificant difference between responders and non-responders (93% v. 90%; P = 0.45), while baseline HOMA was significantly higher in non-responders (10.11 ± 3.03 vs. 8.48 ± 2.98; P = 0.01). Also, post-therapy IR had insignificant difference between both groups (73.3% vs. 85%; P = 0.05), while post-therapy HOMA was significantly higher in non-responders (7.12 ± 2.31 vs. 5.06 ± 1.34; P = 0.01). Predictors of non-responders were age (> 40 years), low serum albumin and post-therapy IR. Conclusion: Baseline IR had no impact on SVR but it showed significant improvement in presence of SVR.
背景与目的:HCV感染是我国主要的健康问题之一。慢性HCV感染患者中糖尿病患病率较高。胰岛素抵抗(IR)在此类疾病中很常见，但其对持续病毒学反应(SVR)的影响尚未得到很好的研究。本研究旨在评估IR对SVR的影响。患者及方法:2016年7月~ 2017年6月;200名慢性HCV感染患者被纳入一项前瞻性研究。排除标准包括失代偿期肝硬化、肝细胞癌或肝外恶性肿瘤、合并HBV感染或HIV感染。在治疗基线和治疗后3个月评估HOMA和IR。患者接受索非布韦和daclatasvir治疗3个月(慢性肝炎)，6个月(肝硬化)。结果:患者平均年龄49.89±9.01岁，男性111例(55.5%)，SVR达到180例(90%)。基线IR在应答者和无应答者之间差异不显著(93% vs 90%;P = 0.45)，而无应答者的基线HOMA显著高于无应答者(10.11±3.03 vs 8.48±2.98;P = 0.01)。此外，两组治疗后IR差异不显著(73.3% vs. 85%;P = 0.05)，而治疗后无应答者HOMA显著高于治疗后无应答者(7.12±2.31∶5.06±1.34;P = 0.01)。无应答的预测因子为年龄(40 ~ 40岁)、低血清白蛋白和治疗后IR。结论:基线IR对SVR无影响，但SVR的存在可显著改善SVR。
{"title":"Impact of Insulin Resistance on Therapeutic Response to Oral Treatment of Chronic Hepatitis C Virus Infection","authors":"M. Hassan, Soha Saoud Abd El Monem, A. Hasanain, Rasha Hosny Sayed, Amal Aziz","doi":"10.17554/j.issn.2224-3992.2020.09.888","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.888","url":null,"abstract":"Background& aim: HCV infection is one of the major health problems in our country. Prevalence of DM is higher among patients with chronic HCV infection. Insulin resistance (IR) is common in such and its impact on sustained virological response (SVR) is not well studied. This work was designed to assess impact of IR on SVR. Patients & methods: Between July 2016 and June 2017; 200 patients with chronic HCV infection were enrolled in a prospective study. Exclusion criteria included decompensated cirrhosis, hepatocellular carcinoma or extrahepatic malignancy, co-infection with HBV or HIV infection. HOMA and IR were assessed at baseline of therapy and 3-months post-therapy. Patients received sofosbuvir and daclatasvir for 3 months (chronic hepatitis) and for 6 months in (liver cirrhosis). Results: Mean age of patients was 49.89 ± 9.01 years, 111 (55.5%) patients were male and 180 (90%) achieved SVR. Baseline IR had insignificant difference between responders and non-responders (93% v. 90%; P = 0.45), while baseline HOMA was significantly higher in non-responders (10.11 ± 3.03 vs. 8.48 ± 2.98; P = 0.01). Also, post-therapy IR had insignificant difference between both groups (73.3% vs. 85%; P = 0.05), while post-therapy HOMA was significantly higher in non-responders (7.12 ± 2.31 vs. 5.06 ± 1.34; P = 0.01). Predictors of non-responders were age (> 40 years), low serum albumin and post-therapy IR. Conclusion: Baseline IR had no impact on SVR but it showed significant improvement in presence of SVR.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46511743","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 : 2020-02-21DOI: 10.17554/j.issn.2224-3992.2020.09.884
M. Hashim, Maha Alsabaawy, S. Afify, Gaser El-Azab, N. Omar
Introduction and aim: Post-liver transplant recipients present a vast array of metabolic disturbances in the post-transplant period which impact on their morbidity and mortality. Post-transplant diabetes and hypertension were associated with increased risks of graft failure, infection, cardiovascular disease, and death. Therefore, predicting and preventing post-transplant metabolic complications would be a compelling objective for improving care of post-transplant recipients. The aim of this study was to identify the incidence and risk factors of metabolic complications after liver transplantation. Methods: Incidence and risk factors for new onset arterial hypertension, diabetes mellitus and hyperlipidemia were assessed progressively in 100 post- liver transplant recipients at least one year after transplantation (91% male; mean age 52 ± 7.7 y). Risk factors were assessed using logistic regression analysis according to demographic, clinical and laboratory variables. Results: The incidence of hypertension was 38.6%; diabetes, 39.7% and hyperlipidemia, 19% at one year post-liver transplantation (LTX). Independent risk factors for new onset of hypertension were family history of hypertension (OR: 4.85; 95% CI: 3.04-7.74), and cyclosporine use (OR: 6.33; 95%CI: 2.36-16.96). Risk factor for new onset of diabetes were HCV infection (OR: 2.54; 95%CI: 0.84-7.72) and cyclosporine use (12.63; 95%CI: 3.06-52.09). The incidence of hyperlipidemia after LTX was related to the use of cyclosporine (OR: 1.56; 95%CI: 1.04-1.98), or tacrolimus (OR: 1.34; 95%CI: 1.02-1.67). Conclusion: LTX was associated with significantly increased rates of hypertension, diabetes and hyperlipidemia. Furthermore, the incidences of these disorders were related to immunosuppressive therapy.
{"title":"Incidence and Risk Factors for Diabetes, Hypertension and Hyperlipidemia after Liver Transplantation","authors":"M. Hashim, Maha Alsabaawy, S. Afify, Gaser El-Azab, N. Omar","doi":"10.17554/j.issn.2224-3992.2020.09.884","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.884","url":null,"abstract":"Introduction and aim: Post-liver transplant recipients present a vast array of metabolic disturbances in the post-transplant period which impact on their morbidity and mortality. Post-transplant diabetes and hypertension were associated with increased risks of graft failure, infection, cardiovascular disease, and death. Therefore, predicting and preventing post-transplant metabolic complications would be a compelling objective for improving care of post-transplant recipients. The aim of this study was to identify the incidence and risk factors of metabolic complications after liver transplantation. Methods: Incidence and risk factors for new onset arterial hypertension, diabetes mellitus and hyperlipidemia were assessed progressively in 100 post- liver transplant recipients at least one year after transplantation (91% male; mean age 52 ± 7.7 y). Risk factors were assessed using logistic regression analysis according to demographic, clinical and laboratory variables. Results: The incidence of hypertension was 38.6%; diabetes, 39.7% and hyperlipidemia, 19% at one year post-liver transplantation (LTX). Independent risk factors for new onset of hypertension were family history of hypertension (OR: 4.85; 95% CI: 3.04-7.74), and cyclosporine use (OR: 6.33; 95%CI: 2.36-16.96). Risk factor for new onset of diabetes were HCV infection (OR: 2.54; 95%CI: 0.84-7.72) and cyclosporine use (12.63; 95%CI: 3.06-52.09). The incidence of hyperlipidemia after LTX was related to the use of cyclosporine (OR: 1.56; 95%CI: 1.04-1.98), or tacrolimus (OR: 1.34; 95%CI: 1.02-1.67). Conclusion: LTX was associated with significantly increased rates of hypertension, diabetes and hyperlipidemia. Furthermore, the incidences of these disorders were related to immunosuppressive therapy.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42082163","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 : 2020-02-21DOI: 10.17554/j.issn.2224-3992.2020.09.883
Abdul Kouanda, Adam Tabbaa, J. Sewell, D. Selvig, L. Day
AIMS: Gastrointestinal endoscopic procedures are commonly performed outpatient procedures associated with adverse events that may lead to emergency department visits. Establishing risk factor for post-endoscopy emergency department visits may guide quality improvement efforts. MATERIALS AND METHODS: Matched case control study of patients over the age of 18 presenting to the emergency department of a safety-net hospital within two weeks of any outpatient endoscopic procedure between July 1, 2013 and December 31, 2014. Controls were matched to cases by age, sex, procedure type, date, and day of week procedure was performed. Univariable and multivariable analysis were performed to identify predictors of emergency visits after endoscopy. REULTS: We identified 143 cases from a total of 6,601 outpatient procedures during the study period. 64 (44.8%) of the visits were attributed to the procedure yielding a visit rate of 0.97%. Compared to controls, cases were more likely to have MediCal (Medicaid) insurance (75.7% vs 59.2%, p = 0.003), prior ED visits (2.5 vs 0.5, p < 0.001), multiple primary care visits (4.9 vs 3.3, p < 0.001), trainee involvement (62.9% vs 44.4%, p = 0.002), and speak English (67.1% vs 54.9%, p = 0.04). On multivariable analysis of cases with visits attributable to the procedure, antiplatelet/anticoagulant use (OR 2.81, CI 1.07-7.34, p = 0.04), MediCal insurance (OR 2.55, CI 1.02-6.40, p = 0.05), multiple ED visits per year (OR 3.31, CI 2.22-4.94, p < 0.001), number of endoscopic interventions (OR 1.22, CI 1.06-1.40, p = 0.006), and trainee involvement (OR 2.55, CI 1.09-5.97, p = 0.03) were all risk factors for post-procedure visits. CONCLUSION: In a safety-net system, medically complex patients, greater number of endoscopic interventions, and lower socioeconomic status may influence emergency department utilization after endoscopy. This information may inform future quality improvement efforts.
{"title":"Predictors of Emergency Visits Within 14 Days of Outpatient Endoscopy at A Safety-Net Hospital: A Case-Control Study","authors":"Abdul Kouanda, Adam Tabbaa, J. Sewell, D. Selvig, L. Day","doi":"10.17554/j.issn.2224-3992.2020.09.883","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.883","url":null,"abstract":"AIMS: Gastrointestinal endoscopic procedures are commonly performed outpatient procedures associated with adverse events that may lead to emergency department visits. Establishing risk factor for post-endoscopy emergency department visits may guide quality improvement efforts. MATERIALS AND METHODS: Matched case control study of patients over the age of 18 presenting to the emergency department of a safety-net hospital within two weeks of any outpatient endoscopic procedure between July 1, 2013 and December 31, 2014. Controls were matched to cases by age, sex, procedure type, date, and day of week procedure was performed. Univariable and multivariable analysis were performed to identify predictors of emergency visits after endoscopy. REULTS: We identified 143 cases from a total of 6,601 outpatient procedures during the study period. 64 (44.8%) of the visits were attributed to the procedure yielding a visit rate of 0.97%. Compared to controls, cases were more likely to have MediCal (Medicaid) insurance (75.7% vs 59.2%, p = 0.003), prior ED visits (2.5 vs 0.5, p < 0.001), multiple primary care visits (4.9 vs 3.3, p < 0.001), trainee involvement (62.9% vs 44.4%, p = 0.002), and speak English (67.1% vs 54.9%, p = 0.04). On multivariable analysis of cases with visits attributable to the procedure, antiplatelet/anticoagulant use (OR 2.81, CI 1.07-7.34, p = 0.04), MediCal insurance (OR 2.55, CI 1.02-6.40, p = 0.05), multiple ED visits per year (OR 3.31, CI 2.22-4.94, p < 0.001), number of endoscopic interventions (OR 1.22, CI 1.06-1.40, p = 0.006), and trainee involvement (OR 2.55, CI 1.09-5.97, p = 0.03) were all risk factors for post-procedure visits. CONCLUSION: In a safety-net system, medically complex patients, greater number of endoscopic interventions, and lower socioeconomic status may influence emergency department utilization after endoscopy. This information may inform future quality improvement efforts.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42302612","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}
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