The Risk of Esophageal Food Impaction in Eosinophilic Esophagitis Patients: The Role of Clinical and Socioeconomic Factors.

IF 2.5 Q2 GASTROENTEROLOGY & HEPATOLOGY
Clinical and Experimental Gastroenterology Pub Date : 2022-09-15 eCollection Date: 2022-01-01 DOI:10.2147/CEG.S364994
Tarik Alhmoud, Sami Ghazaleh, Marcel Ghanim, Roberta E Redfern
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引用次数: 1

Abstract

Background: Eosinophilic esophagitis (EoE) patients present with dysphagia and often suffer from esophageal food impaction (EFI). EFI can lead to life-threatening perforation, and requires emergent endoscopic intervention. The aim of this study is to evaluate the risk factors for EFI in EoE patients.

Methods: This is a retrospective study performed at a tertiary health-care system. Medical records and endoscopy images of EoE cases were reviewed. Clinical characteristics and outcomes including EFIs were documented. We used Zip-code median household income as a surrogate for patients' socioeconomic status.

Results: A total of 291 EoE cases were included, mean age was 42 years. Most patients (65%) had classic EoE endoscopic findings including linear furrows and/or concentric rings; however, a significant proportion (47%) had findings suggestive of gastroesophageal reflux disease (GERD), such as the presence of erosive-esophagitis, a hiatal hernia or Schatzki's ring. Forty-eight patients (16%) developed one or more esophageal food impaction (EFI). The risk of EFI was less likely in the absence of furrows and/or rings; odds ratio (OR) = 0.28, 95% CI (0.11, 0.72) [P = 0.008]. Females had less EFI risk; OR = 0.42, 95% CI (0.19, 0.95) [P = 0.04]. The type of medical insurance and socioeconomic status was not associated with EFI risk.

Conclusion: EFI risk is higher in EoE patients with esophageal furrows and/or rings and in men. Aggressive treatment might be required in this population. GERD and EoE can coexist in many patients. Further studies are required to examine the role of the socioeconomic status in EoE complications.

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嗜酸性粒细胞性食管炎患者发生食管食物嵌塞的风险:临床和社会经济因素的作用
背景:嗜酸性粒细胞性食管炎(EoE)患者表现为吞咽困难,常伴有食管食物嵌塞(EFI)。EFI可导致危及生命的穿孔,需要紧急内镜干预。本研究的目的是评估EoE患者EFI的危险因素。方法:这是一项在三级卫生保健系统进行的回顾性研究。回顾了EoE病例的医疗记录和内窥镜图像。记录临床特征和结果,包括efi。我们使用邮政编码的家庭收入中位数作为患者社会经济地位的替代。结果:共纳入291例EoE病例,平均年龄42岁。大多数患者(65%)有典型的EoE内窥镜检查结果,包括线性沟和/或同心圆;然而,相当大比例(47%)的患者有胃食管反流病(GERD)的表现,如糜烂性食管炎、裂孔疝或沙茨基氏环。48例(16%)患者出现一种或多种食管食物嵌塞(EFI)。在没有沟和/或环的情况下,EFI的风险较低;优势比(OR) = 0.28, 95% CI (0.11, 0.72) [P = 0.008]。女性EFI风险较低;Or = 0.42, 95% ci (0.19, 0.95) [p = 0.04]。医疗保险类型和社会经济地位与EFI风险无关。结论:伴有食管沟和/或食管环的EoE患者和男性EFI风险较高。在这个人群中可能需要积极的治疗。GERD和EoE可在许多患者中共存。需要进一步的研究来检验社会经济地位在EoE并发症中的作用。
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来源期刊
Clinical and Experimental Gastroenterology
Clinical and Experimental Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.10
自引率
0.00%
发文量
26
审稿时长
16 weeks
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