Functional dyspepsia is a common health problem found in society. Few of multifactorial aspects which become the underlying cause of functional dyspepsia are anxiety and psychosocial problem. Esophagogastroduodenoscopy (EGD) examination can display exact information to patient with functional dyspepsia and expected to increase patient’s quality of life. It is still necessary to evaluate the advantages of EGD examination in improving patient’s quality of life.A Randomized double blind controlled trial was conducted to compare between group of patients who have been given an empiric treatment(Proton pump inhibitor and prokinetic agents) and other who have been given a placebo for 2 weeks after underwent EGD examination in patients with functional dyspepsia. The primary outcome of this study is the decrease of NDI-SF score on both of groups at the end of study.A total of 42 patients (22 in EGD+placebo group [Group I] and 20 in EGD + treatment group[Group II]) were enrolled. NDI-SF score decreased significantly in both groups, Group I (26.23±8.43 vs 19.59±7.62, P=0.001) and Group II (27.32±7.57 vs 19.21±5.68, P=0.002), 15 days after underwent EGD examination. NDI-SF score improvement between two groups 15 days after EGD was not significantly different (P=0.814). This study showed improvement in quality of life of patients whom diagnosed with functional dyspepsia after EGD examination in both groups. This improvement was not significantly different between two groups and showed the placebo effect of EGD on functional dyspepsia patient.
功能性消化不良是社会上常见的健康问题。焦虑和社会心理问题是导致功能性消化不良的几个重要因素。食管胃十二指肠镜检查能准确显示功能性消化不良患者的信息，有望提高患者的生活质量。评价EGD检查在提高患者生活质量方面的优势仍有必要。我们进行了一项随机双盲对照试验，比较功能性消化不良患者在接受EGD检查后给予经验性治疗(质子泵抑制剂和促动力学药物)和另一组给予安慰剂2周的患者。本研究的主要结局是两组在研究结束时NDI-SF评分的下降。共纳入42例患者，其中EGD+安慰剂组[组I] 22例，EGD+治疗组[组II] 20例。EGD检查15 d后，两组患者NDI-SF评分均显著降低，ⅰ组(26.23±8.43 vs 19.59±7.62,P=0.001)，ⅱ组(27.32±7.57 vs 19.21±5.68,P=0.002)。EGD后15 d两组NDI-SF评分改善无显著性差异(P=0.814)。本研究显示两组经EGD检查诊断为功能性消化不良的患者的生活质量均有改善。这一改善在两组间无显著差异，显示了EGD对功能性消化不良患者的安慰剂效应。
{"title":"Differences In quality of life between patients with functional dyspepsia after esophagogastroduodenoscopy with empiric treatment and placebo","authors":"S. Sumardjo, N. Ratnasari, P. Bayupurnama","doi":"10.53388/ghr2021-06-034","DOIUrl":"https://doi.org/10.53388/ghr2021-06-034","url":null,"abstract":"Functional dyspepsia is a common health problem found in society. Few of multifactorial aspects which become the underlying cause of functional dyspepsia are anxiety and psychosocial problem. Esophagogastroduodenoscopy (EGD) examination can display exact information to patient with functional dyspepsia and expected to increase patient’s quality of life. It is still necessary to evaluate the advantages of EGD examination in improving patient’s quality of life.A Randomized double blind controlled trial was conducted to compare between group of patients who have been given an empiric treatment(Proton pump inhibitor and prokinetic agents) and other who have been given a placebo for 2 weeks after underwent EGD examination in patients with functional dyspepsia. The primary outcome of this study is the decrease of NDI-SF score on both of groups at the end of study.A total of 42 patients (22 in EGD+placebo group [Group I] and 20 in EGD + treatment group[Group II]) were enrolled. NDI-SF score decreased significantly in both groups, Group I (26.23±8.43 vs 19.59±7.62, P=0.001) and Group II (27.32±7.57 vs 19.21±5.68, P=0.002), 15 days after underwent EGD examination. NDI-SF score improvement between two groups 15 days after EGD was not significantly different (P=0.814). This study showed improvement in quality of life of patients whom diagnosed with functional dyspepsia after EGD examination in both groups. This improvement was not significantly different between two groups and showed the placebo effect of EGD on functional dyspepsia patient.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80639777","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":"Analysis of the Effective Mechanism of Fructus Aurantii Immaturus in the Treatment of Chronic Atrophic Gastritis Based on Network Pharmacology and Molecular Docking Technology","authors":"Jing-Nuan Wu, Yingbing Mei, Nierui Huang, Sisi Li","doi":"10.53388/ghr2021-03-028","DOIUrl":"https://doi.org/10.53388/ghr2021-03-028","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"16 1-2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78252534","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}
Neguemadji Ngardig, Kankeu Tonpouwo, Maryan Gelle, Alla-hein Appolinaire, B. Boy, N. Hange, Manoj Kumar, Sana Irfan, Lemingar Dessinsa, M. Kezia
Introduction: Globally Severe acute malnutrition(SAM) affects more than 29 million children under the age of five. Demographic and Health Survey and Multiple Indicators in Chad (EDS-MICS) of 2014-2015 survey found an acute malnutrition level of 13% out of which 9% was moderate and 4% was severe. The Causes of SAMS are multifactorial, relating to multiple domains such as society, culture, environment, education, livelihoods, agriculture, water, hygiene, etc. Despite this established evidence, the evidence of parental knowledge is unknown. Objective: The objective of our study was to determine the explanatory factors of SAM and its level of knowledge, understanding by the parents. Materials and Methods: A prospective descriptive study was conducted in 238 children aged 6-59 months admitted to therapeutic nutritional unit Alerte Santé of Ndjamena from November 15 to December 30, 2017. Results: During the study, the male sex (58.8%), the age group of 12-17 months (26.9%) and 6-8 months (24.4%) were the most represented and are the majorities in the urban area (72.3%). We were able to identify the various explanatory factors among which the level of education of mothers (62.2%), exclusive breastfeeding (2.3%), the food taboo (81%) are not insignificant. Malnutrition would be decompensated by the breakdown of food access (59%) and digestive diseases (74.8%) and respiratory diseases (73.5%). We found that parents have poor knowledge of malnutrition (87%). Conclusion: A good understanding of these main factors of malnutrition by parents might help to effectively combat severe acute malnutrition.
{"title":"Explanatory Factors for Severe Acute Malnutrition in 6 - 59 months of age Patients Admitted in the Therapeutic Nutritional Unit of N’Djamena, Chad","authors":"Neguemadji Ngardig, Kankeu Tonpouwo, Maryan Gelle, Alla-hein Appolinaire, B. Boy, N. Hange, Manoj Kumar, Sana Irfan, Lemingar Dessinsa, M. Kezia","doi":"10.53388/ghr2021-06-033","DOIUrl":"https://doi.org/10.53388/ghr2021-06-033","url":null,"abstract":"Introduction: Globally Severe acute malnutrition(SAM) affects more than 29 million children under the age of five. Demographic and Health Survey and Multiple Indicators in Chad (EDS-MICS) of 2014-2015 survey found an acute malnutrition level of 13% out of which 9% was moderate and 4% was severe. The Causes of SAMS are multifactorial, relating to multiple domains such as society, culture, environment, education, livelihoods, agriculture, water, hygiene, etc. Despite this established evidence, the evidence of parental knowledge is unknown. Objective: The objective of our study was to determine the explanatory factors of SAM and its level of knowledge, understanding by the parents. Materials and Methods: A prospective descriptive study was conducted in 238 children aged 6-59 months admitted to therapeutic nutritional unit Alerte Santé of Ndjamena from November 15 to December 30, 2017. Results: During the study, the male sex (58.8%), the age group of 12-17 months (26.9%) and 6-8 months (24.4%) were the most represented and are the majorities in the urban area (72.3%). We were able to identify the various explanatory factors among which the level of education of mothers (62.2%), exclusive breastfeeding (2.3%), the food taboo (81%) are not insignificant. Malnutrition would be decompensated by the breakdown of food access (59%) and digestive diseases (74.8%) and respiratory diseases (73.5%). We found that parents have poor knowledge of malnutrition (87%). Conclusion: A good understanding of these main factors of malnutrition by parents might help to effectively combat severe acute malnutrition.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87947797","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":"Focus on microvascular invasion in hepatocellular carcinoma: a pathological perspective","authors":"Han Wang, Wen-Ling Cong","doi":"10.53388/ghr2021-03-031","DOIUrl":"https://doi.org/10.53388/ghr2021-03-031","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82733988","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 : 2020-12-31DOI: 10.24966/GHR-2566/100030
Teresa Gómez
{"title":"Hospital Reconversion of the Gastrointestinal Endoscopy Service at The National Medical Center November 20 Issste During the Covid-19 Pandemic","authors":"Teresa Gómez","doi":"10.24966/GHR-2566/100030","DOIUrl":"https://doi.org/10.24966/GHR-2566/100030","url":null,"abstract":"","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"75 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87838084","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 : 2020-12-21DOI: 10.17554/j.issn.2224-3992.2020.09.977
M. B. Bestari, S. Abdurachman
Corona-virus disease (COVID-19) affected medical services worldwide because of its pandemic nature; including patients with chronic liver disease (CLD). Generally, there are three situations in which CLD patients can be affected by the coronavirus. Patients who have pre-existing liver conditions, especially those that need constant follow-up, will be exposed during follow-up visits to the hospital and are more vulnerable to infection. Second, patients with COVID-19 who have liver function derangements and incidental findings of ongoing CLD, especially those with cirrhosis will have more severe courses of the disease and possible acute-on-chronic liver failure. Finally, patients who undergo treatment for CLD who are infected with COVID-19, where drug-drug interactions are possible (e.g. lopinavir-ritonavir) that may increase the concentration of the protease inhibitor DAA for Hepatitis C treatment. This review is aims to provide guidelines for managing patients with CLD amid the pandemic, and how we move forward after the lockdown.
{"title":"The Liver’s Fate Amid COVID-19 Pandemic","authors":"M. B. Bestari, S. Abdurachman","doi":"10.17554/j.issn.2224-3992.2020.09.977","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.977","url":null,"abstract":"Corona-virus disease (COVID-19) affected medical services worldwide because of its pandemic nature; including patients with chronic liver disease (CLD). Generally, there are three situations in which CLD patients can be affected by the coronavirus. Patients who have pre-existing liver conditions, especially those that need constant follow-up, will be exposed during follow-up visits to the hospital and are more vulnerable to infection. Second, patients with COVID-19 who have liver function derangements and incidental findings of ongoing CLD, especially those with cirrhosis will have more severe courses of the disease and possible acute-on-chronic liver failure. Finally, patients who undergo treatment for CLD who are infected with COVID-19, where drug-drug interactions are possible (e.g. lopinavir-ritonavir) that may increase the concentration of the protease inhibitor DAA for Hepatitis C treatment. This review is aims to provide guidelines for managing patients with CLD amid the pandemic, and how we move forward after the lockdown.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"9 1","pages":"3367-3372"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42425677","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 : 2020-12-21DOI: 10.17554/j.issn.2224-3992.2020.09.975
Vimala Alagappan, Ripal Shah, Robert C. Meisner
As research on the interplay of nutrition and mental health evolves, “nutritional medicine” is attracting new enthusiasm from clinicians across a broad range of clinical subspecialties. In this review, we describe potential relevance of 6 nutrients in particular — Vitamin A, Vitamin C, Zinc, Magnesium, L-tryptophan, and Omega-3 fatty acids — on reducing or preventing the target symptoms of stress and aggression. Briefly: (1) Vitamin A may reduce the physical symptoms of stress, including inflammation, while (2) Vitamin C may reduce psychological distress and attenuate acute mammalian stress-response; stress may (3) increase the body’s demand for Mg and exacerbate Mg deficiency, while Mg deficiency itself may increase vulnerability under particular stressors; (4) Zinc deficiency appears to correlate with psychological adaptive potential; (5) Omega-3 fatty acids may mitigate aggression and anger for stressed mammalians. Tryptophan (6) depletion, finally, appears to correlate with increased aggression. Broadly speaking, as the literature evolves, there increasingly appears to be meaningful correlations between these nutrients and stress and aggression that justifies a call for further research.
{"title":"The Effects of Nutrients on Stress and Aggression: Integrative Approaches to Behavioral and Emotional Modification","authors":"Vimala Alagappan, Ripal Shah, Robert C. Meisner","doi":"10.17554/j.issn.2224-3992.2020.09.975","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.975","url":null,"abstract":"As research on the interplay of nutrition and mental health evolves, “nutritional medicine” is attracting new enthusiasm from clinicians across a broad range of clinical subspecialties. In this review, we describe potential relevance of 6 nutrients in particular — Vitamin A, Vitamin C, Zinc, Magnesium, L-tryptophan, and Omega-3 fatty acids — on reducing or preventing the target symptoms of stress and aggression. Briefly: (1) Vitamin A may reduce the physical symptoms of stress, including inflammation, while (2) Vitamin C may reduce psychological distress and attenuate acute mammalian stress-response; stress may (3) increase the body’s demand for Mg and exacerbate Mg deficiency, while Mg deficiency itself may increase vulnerability under particular stressors; (4) Zinc deficiency appears to correlate with psychological adaptive potential; (5) Omega-3 fatty acids may mitigate aggression and anger for stressed mammalians. Tryptophan (6) depletion, finally, appears to correlate with increased aggression. Broadly speaking, as the literature evolves, there increasingly appears to be meaningful correlations between these nutrients and stress and aggression that justifies a call for further research.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44005271","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 : 2020-12-21DOI: 10.17554/j.issn.2224-3992.2020.09.981
M. Maher, Hazem M Rizk
The COVID-19 pandemic, caused by coronavirus 2 (SARS-CoV-2), has developed as a intense challenge for healthcare systems allover the world. COVID-19 can be associated with gastrointestinal (GI) inflammation as SARS-CoV-2 enters cells via its receptor the angiotensin-converting enzyme 2, which is expressed on GI cells. There was a great demand to clarify the impact of COVID-19 on patients with inflammatory bowel disease (IBD), particularly those on immunosuppressive medications.
{"title":"COVID-19 Outbreak and IBD Patient: A Challenge","authors":"M. Maher, Hazem M Rizk","doi":"10.17554/j.issn.2224-3992.2020.09.981","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.981","url":null,"abstract":"The COVID-19 pandemic, caused by coronavirus 2 (SARS-CoV-2), has developed as a intense challenge for healthcare systems allover the world. COVID-19 can be associated with gastrointestinal (GI) inflammation as SARS-CoV-2 enters cells via its receptor the angiotensin-converting enzyme 2, which is expressed on GI cells. There was a great demand to clarify the impact of COVID-19 on patients with inflammatory bowel disease (IBD), particularly those on immunosuppressive medications.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"9 1","pages":"3354-3356"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45953219","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 : 2020-10-21DOI: 10.17554/j.issn.2224-3992.2020.09.968
H. Ono, H. Yokoyama, H. Yoshida, H. Fukushima, M. Kawakami, M. Okamura, T. Aoki, N. Asakage, K. Nagashima, Y. Danjo, H. Hayashi, H. Nishihara, Y. Shimizu, T. Shimamura, M. Kusano
AIM: A colocutaneous fistula is a rare late complication of percutaneous endoscopic gastrostomy (PEG) feeding placement that occurs as a result of the interposition of the colon between the anterior abdominal and gastric walls. In the current study, we sought to retrospectively study the method of introducing the water-soluble contrast agent into the stomach by using a nasogastric tube before PEG feeding placement, with the intention to develop a method to prevent PEG-related colocutaneous fistula. MATERIALS AND METHODS: Between October 2003 and April 2020, 341 patients underwent PEG placement at Seiwa Memorial Hospital. Patients were divided into two groups: 232 patients in Group A were given water-soluble contrast agent and 109 patients in Group B were not. All patients underwent PEG using introducer method placement after gastropexy under fluoroscopy. RESULTS: In Group A, 139 (59.9%) patients received PEG with a water-soluble contrast agent placed into the transverse colon, 75 (32.3%) received PEG with gas in the colon, and 7 (3.0%) patients received surgical gastrostomy. In Group B, 38 (34.8%) patients received PEG with gas in the colon, 60 (55.1%) patients received PEG with finger palpation and transillumination, and 10 (9.2%) patients received surgical gastrostomy. Colocutaneous fistula was not observed in either group, but there was a significant difference in the frequency of surgical gastrostomy between Group A and B ( p = 0.0148). CONCLUSION: The use of water-soluble contrast agent in the stomach was safe, reliable, and cost effective for PEG tube placement, and is recommended to decrease surgical gastrostomy.
{"title":"Prevention of PEG Tube Misplacement in the Transverse Colon: Method of Introducing a Gastrografin into the Stomach","authors":"H. Ono, H. Yokoyama, H. Yoshida, H. Fukushima, M. Kawakami, M. Okamura, T. Aoki, N. Asakage, K. Nagashima, Y. Danjo, H. Hayashi, H. Nishihara, Y. Shimizu, T. Shimamura, M. Kusano","doi":"10.17554/j.issn.2224-3992.2020.09.968","DOIUrl":"https://doi.org/10.17554/j.issn.2224-3992.2020.09.968","url":null,"abstract":"AIM: A colocutaneous fistula is a rare late complication of percutaneous endoscopic gastrostomy (PEG) feeding placement that occurs as a result of the interposition of the colon between the anterior abdominal and gastric walls. In the current study, we sought to retrospectively study the method of introducing the water-soluble contrast agent into the stomach by using a nasogastric tube before PEG feeding placement, with the intention to develop a method to prevent PEG-related colocutaneous fistula. MATERIALS AND METHODS: Between October 2003 and April 2020, 341 patients underwent PEG placement at Seiwa Memorial Hospital. Patients were divided into two groups: 232 patients in Group A were given water-soluble contrast agent and 109 patients in Group B were not. All patients underwent PEG using introducer method placement after gastropexy under fluoroscopy. RESULTS: In Group A, 139 (59.9%) patients received PEG with a water-soluble contrast agent placed into the transverse colon, 75 (32.3%) received PEG with gas in the colon, and 7 (3.0%) patients received surgical gastrostomy. In Group B, 38 (34.8%) patients received PEG with gas in the colon, 60 (55.1%) patients received PEG with finger palpation and transillumination, and 10 (9.2%) patients received surgical gastrostomy. Colocutaneous fistula was not observed in either group, but there was a significant difference in the frequency of surgical gastrostomy between Group A and B ( p = 0.0148). CONCLUSION: The use of water-soluble contrast agent in the stomach was safe, reliable, and cost effective for PEG tube placement, and is recommended to decrease surgical gastrostomy.","PeriodicalId":90217,"journal":{"name":"Journal of gastroenterology and hepatology research","volume":"9 1","pages":"3320-3324"},"PeriodicalIF":0.0,"publicationDate":"2020-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47249627","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 : 2020-10-21DOI: 10.17554/j.issn.2224-3992.2020.09.973
Yongyue Qi, T. LeVan, G. Haynatzki, C. Are, P. Farazi
Background : Despite advances of surgical techniques, hepatectomy continues to be potentially dangerous and is associated with postoperative mortality, morbidity and readmission. The objective of this study was to determine the effect of 30-day unplanned readmission on ‘conditional’ 90-day mortality among hepatocellular carcinoma (HCC) patients that underwent partial hepatectomy. Methods : National Cancer Database (NCDB) was queried from 2004 to 2012 for patients with hepatocellular carcinoma (HCC) who underwent partial hepatectomy. Thirty-day unplanned readmission rate, and associated risk factors, was determined for 7,696 patients. The association between 30-day unplanned readmission and conditional 90-day mortality was further addressed. Results : The 30-day unplanned readmission rate for patients with HCC that underwent partial hepatectomy was 5.2%. Risk factors associated with 30-day unplanned readmission were sex, race/ethnicity, Charlson-Deyo score, and annual hospital hepatectomy volume. An overall adjusted odds ratio of having conditional 90-day mortality was 2.325 times higher (95% CI 1.643 - 3.219) among patients with a history of 30-day unplanned readmission than those without. This association was dependent on age, sex, race/ethnicity, insurance status, alpha-fetoprotein (AFP), liver fibrosis, Charlson-Deyo comorbidity score and annual hospital hepatectomy volume. Conclusion : Efforts in patient care should be taken to reduce 30-day unplanned readmission after partial hepatectomy for patients with HCC to reduce conditional 90-day mortality.
背景:尽管手术技术不断进步，肝切除术仍然具有潜在的危险，并且与术后死亡率、发病率和再入院率相关。本研究的目的是确定30天计划外再入院对接受部分肝切除术的肝细胞癌(HCC)患者“条件性”90天死亡率的影响。方法:查询国家癌症数据库(NCDB) 2004 - 2012年行肝部分切除术的肝细胞癌(HCC)患者。7696例患者的30天非计划再入院率及相关危险因素被确定。30天非计划再入院与90天有条件死亡率之间的关系得到进一步探讨。结果:行部分肝切除术的HCC患者30天非计划再入院率为5.2%。与30天非计划再入院相关的危险因素有性别、种族/民族、Charlson-Deyo评分和每年住院肝切除量。有30天非计划再入院史的患者有条件90天死亡率的总体调整优势比是无计划再入院史患者的2.325倍(95% CI 1.643 - 3.219)。这种关联依赖于年龄、性别、种族/民族、保险状况、甲胎蛋白(AFP)、肝纤维化、Charlson-Deyo合病评分和每年住院肝切除术量。结论:应加强患者护理，减少HCC患者部分肝切除术后30天的意外再入院，以降低有条件的90天死亡率。
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