Alexandra Strauss Starling, Shivani U Thanawala, Claire A Beveridge, Gary W Falk, Kristle L Lynch
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引用次数: 0
摘要
背景:食管胃交界流出梗阻(EGJOO)是一种基于芝加哥分类4.0 (CC4.0)的压力测量诊断,需要临床相关性的确证性检测。然而,目前尚不清楚哪些患者会对治疗有反应。目的:探讨EGJOO患者血压计及异常确认试验的临床预测因素。设计:这是一项前瞻性观察研究,研究对象是有压力性EGJOO和胸痛或吞咽困难的患者,他们接受了确证性测试。方法:对血压测定为EGJOO的患者进行定时食管钡餐造影或endoFLIP检查。对一部分患者进行了有效的调查,包括Eckardt评分(ES)和promise -10。结果:对于CC4.0 EGJOO诊断的患者,肠蠕动异常(OR = 7.0, 95% CI = 1.01-44.6, p = 0.04)和ES升高(OR = 2.34, 95% CI = 1.13-4.86, p = 0.02)与确认试验阳性相关。结论:具有潜在可行动性EGJOO的患者更有可能出现EGJOO的异常蠕动亚型或更高的ES。
Look above the IRP: predicting abnormal confirmatory testing in patients with esophagogastric junction outflow obstruction.
Background: Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on Chicago Classification version 4.0 (CC4.0) that requires confirmatory testing for clinical relevancy. However, it is still unclear which patients will respond to therapy.
Objectives: To evaluate manometric and clinical predictors of abnormal confirmatory testing for patients with EGJOO.
Design: This was a prospective observational study of patients with manometric EGJOO and chest pain or dysphagia who underwent confirmatory testing.
Methods: Patients with EGJOO on manometry were enrolled and underwent timed barium esophagram or endoFLIP. A subset of patients was given validated surveys, including Eckardt scores (ES) and PROMIS-10.
Results: For patients with a CC4.0 EGJOO diagnosis, abnormal peristalsis (OR = 7.0, 95% CI = 1.01-44.6, p = 0.04) and increases in ES (OR = 2.34 95% CI = 1.13-4.86, p = 0.02) were associated with positive confirmatory testing.
Conclusion: Patients with potentially actionable EGJOO were more likely to have an abnormal peristaltic subtype of EGJOO or higher ES.
期刊介绍:
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.