Low Body Mass Index and Risk of Endoscopy-Related Adverse Events: A United States Cohort Propensity Score—Matched Study

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-01-01 DOI:10.1016/j.tige.2023.12.001

Saurabh Chandan , Rahul Karna , Aakash Desai , Babu P. Mohan , Dushyant Singh Dahiya , Daryl Ramai , Antonio Facciorusso , Mohammad Bilal , Douglas G. Adler , Gursimran S. Kochhar

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引用次数: 0

Abstract

Background and Aims

Patients with a low body mass index (LBMI) are often encountered in routine outpatient gastrointestinal (GI) endoscopy practice, and the assessment of procedure-related risks in this subset of individuals remains paramount. Although the risk of endoscopy-related adverse events (AEs) has been reported in patients with obesity, the association between LBMI and AEs has not been established.

Methods

We conducted a retrospective cohort study using TriNetX, a multi-institutional database, to assess the risk of endoscopy-related AEs in patients with LBMI (<18.4 kg/m²) compared with patients with a nonobese body mass index (18.5-29.9 kg/m²) (control cohort) after low-risk outpatient diagnostic esophagogastroduodenoscopy (EGD), colonoscopy, or percutaneous endoscopic gastrostomy (PEG) tube placement. One-to-one (1:1) propensity score matching was performed. The primary endpoints were to assess the risk of GI bleeding, perforation, or aspiration pneumonia within 30 days. Risk was expressed as adjusted odds ratios (aORs) with 95% confidence intervals.

Results

A total of 28,677, 18,449, and 3076 patients with LBMI underwent EGD, colonoscopy, and PEG tube placement, respectively. After propensity score matching, compared with the control cohort, patients with LBMI undergoing EGD and colonoscopy with or without biopsies were at an increased risk for GI bleeding (aOR 1.36 and 2.21), perforation (aOR 1.96 and 2.65), and aspiration pneumonia (aOR 3.13 and 2.71), respectively. Additionally, patients in the LBMI PEG cohort were found to be at an increased risk for aspiration pneumonia (aOR 1.33).

Conclusion

Our study shows that, when compared with nonobese controls, patients with LBMI are at an increased risk of endoscopy-related AEs. Appropriate precautions must be considered while performing routine endoscopic procedures to offset these risks in such patients.

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低体重指数 (LBMI) 与内镜检查相关不良事件的风险 - 一项美国队列倾向分数匹配研究

背景和目的低体重指数（LBMI）患者经常出现在常规门诊胃肠道（GI）内镜检查实践中，对这部分患者进行手术相关风险评估仍然至关重要。方法我们利用多机构数据库 TriNetX 进行了一项回顾性队列研究，评估 LBMI（18.4 kg/m2）患者与肥胖患者发生内镜相关不良事件（AEs）的风险。4 kg/m2）与非肥胖体重指数（18.5-29.9 kg/m2）患者（对照组群）进行低风险门诊诊断性食管胃十二指肠镜检查（EGD）、结肠镜检查或经皮内镜胃造口术（PEG）置管后发生内镜相关 AEs 的风险进行比较。进行了一对一（1:1）倾向得分匹配。主要终点是评估30天内消化道出血、穿孔或吸入性肺炎的风险。结果分别有 28677、18449 和 3076 名 LBMI 患者接受了胃肠镜检查、结肠镜检查和 PEG 管置入术。经过倾向评分匹配后，与对照组相比，接受胃肠镜检查和结肠镜检查并进行或不进行活检的 LBMI 患者发生消化道出血（aOR 1.36 和 2.21）、穿孔（aOR 1.96 和 2.65）和吸入性肺炎（aOR 3.13 和 2.71）的风险分别增加。结论我们的研究表明，与非肥胖对照组相比，LBMI 患者发生内镜相关 AE 的风险更高。在进行常规内窥镜手术时，必须考虑采取适当的预防措施，以抵消这类患者的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.