Cholelithiasis prevalence and risk factors in individuals with severe or profound intellectual and motor disabilities

IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL
A. Watanabe, Y. Tomioka, Y. Okata, S. Yoshimura, S. Kumode, S. Iwabuchi, Y. Kameoka, Y. Takanarita, K. Uemura, Y. Samejima, Y. Kawasaki, Y. Bitoh
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Abstract

Background

The prevalence and risk factors of cholelithiasis in individuals with severe or profound intellectual and motor disabilities (SPIMD) are poorly characterised. Thus, we aimed to investigate the prevalence and risk determinants of cholelithiasis in a cohort with SPIMD under medical care in a residential facility.

Methods

We categorised 84 patients in a residential hospital for persons with SPIMD into groups: those with (Group CL) and without (Group N) cholelithiasis. Gallstones were detected via computed tomography, ultrasonography or both. We evaluated gastrostomy status, nutritional and respiratory support, constipation, and bladder and kidney stones. Data were significantly analysed using univariate and multivariate logistic regression analyses.

Results

The prevalence rate of cholelithiasis in our SPIMD cohort was 27%. There were no significant differences in sex, age, weight, height, or Gross Motor Function Classification System between the two groups. However, more patients received enteral nutrition (39.13% vs. 6.56%; P = 0.000751) and were on ventilator support (56.52% vs. 19.67%; P = 0.00249) in Group CL than in Group N. Enteral nutrition [odds ratio (OR) 10.4, 95% confidence interval (CI) 1.98–54.7] and ventilator support (OR 20.0, 95% CI 1.99–201.0) were identified as independent risk factors for the prevalence of cholelithiasis in patients with SPIMD.

Conclusions

Patients with SPIMD demonstrated an increased prevalence of cholelithiasis, with a notable association between nutritional tonic use and respiratory support. Therefore, to emphasise the need for proactive screening, it is crucial to devise diagnostic and therapeutic strategies specific to patients with SPIMD. Further investigation is essential to validate our findings and explore causative factors.

重度或极重度智力和运动障碍患者的胆石症患病率和风险因素。
背景:对重度或极重度智力和运动障碍患者(SPIMD)胆石症的患病率和风险因素了解甚少。因此,我们旨在调查在寄宿机构接受医疗护理的 SPIMD 患者中胆石症的患病率和风险决定因素:我们将一家为 SPIMD 患者提供住院治疗的医院的 84 名患者分为两组:有胆石症(CL 组)和无胆石症(N 组)。胆结石通过计算机断层扫描、超声波检查或两者同时进行检测。我们对胃造瘘情况、营养和呼吸支持、便秘、膀胱和肾结石进行了评估。通过单变量和多变量逻辑回归分析对数据进行了重要分析:结果:我们的SPIMD队列中胆石症的发病率为27%。两组患者在性别、年龄、体重、身高或粗大运动功能分级系统方面无明显差异。然而,与 N 组相比,CL 组接受肠内营养(39.13% 对 6.56%;P = 0.000751)和呼吸机支持(56.52% 对 19.67%;P = 0.00249)的患者更多。4,95% 置信区间 (CI) 1.98-54.7]和呼吸机支持(OR 20.0,95% CI 1.99-201.0)被确定为 SPIMD 患者胆石症患病率的独立风险因素:结论:SPIMD 患者的胆石症发病率较高,营养补品的使用与呼吸机支持之间存在显著关联。因此,为了强调主动筛查的必要性,制定针对 SPIMD 患者的诊断和治疗策略至关重要。为了验证我们的研究结果并探索致病因素,进一步的调查是必不可少的。
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来源期刊
CiteScore
5.60
自引率
5.60%
发文量
81
期刊介绍: The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.
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