Clinics and research in hepatology and gastroenterology最新文献

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Prognostic role of tumor-infiltrating lymphocytes in gastric cancer: A systematic review and meta-analysis 肿瘤浸润淋巴细胞在胃癌预后中的作用:一项系统综述和荟萃分析。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2025-01-01 DOI: 10.1016/j.clinre.2024.102510
Xiaoqing Cao , Yurou Kang , Ping Tai, Pei Zhang, Xin Lin, Fei Xu, Zhenlin Nie, Bangshun He
{"title":"Prognostic role of tumor-infiltrating lymphocytes in gastric cancer: A systematic review and meta-analysis","authors":"Xiaoqing Cao ,&nbsp;Yurou Kang ,&nbsp;Ping Tai,&nbsp;Pei Zhang,&nbsp;Xin Lin,&nbsp;Fei Xu,&nbsp;Zhenlin Nie,&nbsp;Bangshun He","doi":"10.1016/j.clinre.2024.102510","DOIUrl":"10.1016/j.clinre.2024.102510","url":null,"abstract":"<div><h3>Background</h3><div>To analyze the relationship between tumor-infiltrating lymphocytes (TILs) subtypes and infiltration locations and the prognosis of gastric cancer (GC) patients.</div></div><div><h3>Methods</h3><div>Eligible articles were obtained through systematic retrieval and rigorous screening, collecting study information and extracting hazard ratio (HR), 95 % confidence interval (CI) for pooled analyses of disease-free survival (DFS) and overall survival (OS).</div></div><div><h3>Results</h3><div>Higher CD4<sup>+</sup> TILs were correlated with favorable OS (HR=0.79, 95 %CI: 0.66–0.94, <em>P</em> = 0.009), the similar results were observed in tumor center and in infiltration margin. Higher CD8<sup>+</sup> TILs prolonged DFS (HR=0.69, 95 %CI: 0.51–0.95, <em>P</em> = 0.02) and OS (HR=0.96, 95 %CI: 0.94–0.99, <em>P</em> = 0.006); For OS, tumor center and infiltration margin groups showed positive results. Neither the overall analysis nor the subgroup analyses indicated that the level of FOXP3<sup>+</sup> TILs was associated with prognosis (DFS: HR=0.89, 95 %CI: 0.66–1.19, <em>P</em> = 0.42; OS: HR=0.98, 95 %CI: 0.85–1.13, <em>P</em> = 0.75). Pooled results revealed that higher CD3<sup>+</sup> TILs were correlated with favorable DFS (HR=0.69, 95 %CI: 0.56–0.84, <em>P</em> = 0.0003) but not OS (HR=1.00, 95 %CI: 0.99–1.01, <em>P</em> = 0.48).</div></div><div><h3>Conclusions</h3><div>High infiltrating CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>+</sup> T cells prolong survival, and FOXP3<sup>+</sup> subset is not related to prognosis in GC. For CD4<sup>+</sup> and CD8<sup>+</sup>, positive correlations between the infiltration level and OS were present in tumor center and infiltration margin groups.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102510"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring gender disparities in hepatocellular carcinoma: Insights from a French study 探讨肝细胞癌的性别差异:来自法国研究的见解。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2025-01-01 DOI: 10.1016/j.clinre.2024.102518
Héloïse Giudicelli, Manon Allaire
{"title":"Exploring gender disparities in hepatocellular carcinoma: Insights from a French study","authors":"Héloïse Giudicelli,&nbsp;Manon Allaire","doi":"10.1016/j.clinre.2024.102518","DOIUrl":"10.1016/j.clinre.2024.102518","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102518"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Telomere-methylation genes: Novel prognostic biomarkers for hepatocellular carcinoma 端粒甲基化基因:肝细胞癌的新型预后生物标志物
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2025-01-01 DOI: 10.1016/j.clinre.2024.102516
Jia-Wen Xie , Hui-Ling Wang , Ling-Qing Lin , Yin-Feng Guo , Mao Wang , Xiao-Zhen Zhu , Jian-Jun Niu , Li-Rong Lin
{"title":"Telomere-methylation genes: Novel prognostic biomarkers for hepatocellular carcinoma","authors":"Jia-Wen Xie ,&nbsp;Hui-Ling Wang ,&nbsp;Ling-Qing Lin ,&nbsp;Yin-Feng Guo ,&nbsp;Mao Wang ,&nbsp;Xiao-Zhen Zhu ,&nbsp;Jian-Jun Niu ,&nbsp;Li-Rong Lin","doi":"10.1016/j.clinre.2024.102516","DOIUrl":"10.1016/j.clinre.2024.102516","url":null,"abstract":"<div><h3>Background</h3><div>Since telomere length and DNA methylation both correlate with hepatocellular carcinoma (HCC) prognosis, telomere-methylation genes could be novel prognostic markers for HCC.</div></div><div><h3>Method</h3><div>This study first investigated the interaction between telomere length and DNA methylation in HCC through Mendelian randomization analysis. Then, this study identified telomere-methylation genes in HCC by employing the TCGA-LIHC cohort, and explored the expression patterns of these genes in the tumor microenvironment of HCC and potential underlying mechanisms. Finally, the HCC risk-scoring model and prognostic model based on these genes were established, and the performance of the model was assessed.</div></div><div><h3>Result</h3><div>The findings revealed a bidirectional relationship between telomere length and DNA methylation in HCC. Fifty telomere-methylation genes were identified, and the prognosis-related telomere-methylation genes were closely associated with Treg and Tprolif cell subsets within the HCC tumor microenvironment. Telomere-methylation genes could potentially impact the prognosis of HCC patients by modulating chromosome stability and regulating the cell cycle. Additionally, the constructed risk scoring model and prognostic prediction model showcased compelling clinical applicability, as evidenced by the receiver operating characteristic curve, the decision curve analysis, and the calibration curves.</div></div><div><h3>Conclusion</h3><div>This study elucidated the potential of telomere-methylation genes as prognostic biomarkers for HCC and paves the way for novel approaches in prognostication and treatment management for HCC patients.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102516"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis 胆总管结石患者自发胆总管清扫和不必要的 ERCP 的预测因素。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2025-01-01 DOI: 10.1016/j.clinre.2024.102515
Fábio Pereira Correia , Henrique Coelho , Mónica Francisco , Gonçalo Alexandrino , Joana Carvalho Branco , Jorge Canena , David Horta , Luís Carvalho Lourenço
{"title":"Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis","authors":"Fábio Pereira Correia ,&nbsp;Henrique Coelho ,&nbsp;Mónica Francisco ,&nbsp;Gonçalo Alexandrino ,&nbsp;Joana Carvalho Branco ,&nbsp;Jorge Canena ,&nbsp;David Horta ,&nbsp;Luís Carvalho Lourenço","doi":"10.1016/j.clinre.2024.102515","DOIUrl":"10.1016/j.clinre.2024.102515","url":null,"abstract":"<div><h3>Background</h3><div>Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line procedure for choledocholithiasis treatment. However, it is associated with a 10 % rate of adverse events. Spontaneous migration of common bile duct (CBD) stones occurs in 6–33 % of choledocholithiasis cases, making ERCP avoidable. This study aimed to identify predictors of spontaneous CBD stones’ migration.</div></div><div><h3>Methods</h3><div>Retrospective study including patients diagnosed with choledocholithiasis and submitted to ERCP. Patients were divided into 2 groups considering spontaneous stone migration (i.e.: the absence of CBD stones on ERCP). Data on patients’ characteristics, imaging findings, biochemical analysis, and ERCP procedure were analyzed to identify predictors of spontaneous migration of CBD stones.</div></div><div><h3>Results</h3><div>334 patients with a mean age of 71.7 years were included in the study: 76.6 % without and 23.4 % with spontaneous migration of CBD stones. Although some patients’ features (gender and clinical presentation), imaging findings (diameters of the largest stone and CBD), biochemical analysis (bilirubin levels at diagnosis and pre-ERCP), and ERCP procedure characteristics (time from diagnosis to ERCP) were different between groups, only three variables were defined as predictors: the absence of acute cholangitis, the largest stone diameter ≤5 mm, and the bilirubin levels pre-ERCP ≤ 2mg/dL. When using those variables together there was a chance of 81–86 % to correctly distinguishing patients with and without spontaneous CBD stone migration.</div></div><div><h3>Conclusion</h3><div>The size of the largest stone at diagnosis was validated as a predictor of CBD stones’ spontaneous migration. Furthermore, two new predictors were identified: bilirubin levels pre-ERCP ≤ 2 mg/dL, and no acute cholangitis at the clinical presentation of choledocholithiasis. EUS and ERCP in the same session should be considered in patients with factors predictive of stone migration, especially when combined, to minimize unnecessary ERCP and possible complications.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102515"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary hepatic large B-cell lymphoma 原发性肝大 B 细胞淋巴瘤。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-22 DOI: 10.1016/j.clinre.2024.102506
Dan-Lei Han , Jian Zha , Lin-Yan Wan , Wei Liu
{"title":"Primary hepatic large B-cell lymphoma","authors":"Dan-Lei Han ,&nbsp;Jian Zha ,&nbsp;Lin-Yan Wan ,&nbsp;Wei Liu","doi":"10.1016/j.clinre.2024.102506","DOIUrl":"10.1016/j.clinre.2024.102506","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102506"},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safety and efficacy of the enhanced recovery after surgery protocol in hepatectomy for liver cancer 肝癌肝切除术中加强术后恢复方案的安全性和有效性。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-20 DOI: 10.1016/j.clinre.2024.102493
Quan Lv , Ying-Chun Xiang , Yan-Yu Qiu , Zheng Xiang
{"title":"Safety and efficacy of the enhanced recovery after surgery protocol in hepatectomy for liver cancer","authors":"Quan Lv ,&nbsp;Ying-Chun Xiang ,&nbsp;Yan-Yu Qiu ,&nbsp;Zheng Xiang","doi":"10.1016/j.clinre.2024.102493","DOIUrl":"10.1016/j.clinre.2024.102493","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this research was to evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) protocol in hepatectomy patients with liver cancer.</div></div><div><h3>Materials and methods</h3><div>We searched three databases, including PubMed, Embase, and the Cochrane Library database, from inception to April 25, 2023. The outcomes were postoperative complications, and postoperative length of stay (PLOS). This study was performed by Stata (V. 16.0) software.</div></div><div><h3>Results</h3><div>Twelve investigations involving 1,892 patients were included in this study. The ERAS group had lower overall postoperative complications [odds ratio (OR) = 0.49, I² = 54.89 %, 95 % confidence interval (CI) = 0.33–0.74, <em>P</em> = 0.00], postoperative Clavien-Dindo Grade 1–2 complications (OR = 0.39, I² = 55.14 %, 95 %CI = 0.23–0.69, <em>P</em> = 0.00), Clavien-Dindo Grade 3–4 complications (OR = 0.56, I² = 0.00 %, 95 %CI = 0.38–0.83, <em>P</em> = 0.00) , pneumonia (OR = 0.34, I² = 0.00 %, 95 %CI = 0.15–0.76, <em>P</em> = 0.01), ascites (OR = 0.25, I² = 0.00 %, 95 %CI = 0.09–0.68, <em>P</em> = 0.01), vomit (OR = 0.39, I² = 0.00 %, 95 %CI = 0.21–0.73, <em>P</em> = 0.00), intraoperative blood loss [mean difference (MD) = 1.69, I² = 0.00 %, 95 %CI = 1.15–2.47, <em>P</em> = 0.01], PLOS (MD = -0.42, I² = 94.87 %, 95 %CI = -0.86–0.03, <em>P</em> = 0.07), duration of abdominal drain (MD = -1.23, I² = 96.96 %, 95 %CI = -2.04 to -0.42, <em>P</em> = 0.00), and hospital readmission (OR = 0.44, I² = 0.00 %, 95 %CI = 0.23–0.85, <em>P</em> = 0.01) compared to the non-ERAS group.</div></div><div><h3>Conclusion</h3><div>For patients with liver cancer treated with ERAS. The ERAS protocol reduces the percentage of overall postoperative complications. Moreover, ERAS does not increase the rate of blood transfusions, hospital readmission, reoperation, or mortality.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 10","pages":"Article 102493"},"PeriodicalIF":2.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prolonged survival in women with hepatocellular carcinoma: A French observational study 延长肝细胞癌女性患者的生存期:一项法国观察性研究。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-15 DOI: 10.1016/j.clinre.2024.102498
Cécilia Busso , Jean-Charles Nault , Richard Layese , Alix Demory , Lorraine Blaise , Gisèle Nkontchou , Véronique Grando , Pierre Nahon , Nathalie Ganne-Carrié
{"title":"Prolonged survival in women with hepatocellular carcinoma: A French observational study","authors":"Cécilia Busso ,&nbsp;Jean-Charles Nault ,&nbsp;Richard Layese ,&nbsp;Alix Demory ,&nbsp;Lorraine Blaise ,&nbsp;Gisèle Nkontchou ,&nbsp;Véronique Grando ,&nbsp;Pierre Nahon ,&nbsp;Nathalie Ganne-Carrié","doi":"10.1016/j.clinre.2024.102498","DOIUrl":"10.1016/j.clinre.2024.102498","url":null,"abstract":"<div><div>Background and Aim: Less than 25 % of hepatocellular carcinoma (HCC) occurs in women, in whom prognosis could be better. Due to the lack of date in Europe, this study aims to assess survival of patients with HCC according sex in a tertiary French liver center.</div><div>Patients and Methods: Every patient diagnosed with a first diagnosis of HCC presented at our weekly multidisciplinary tumor board between 2013 and 2017 were included. Baseline characteristics of patients and tumors were compared according sex using the Mann-Whitney test for Continuous variables and the Fisher or Chi-square test for dichotomous variables. Survival analyses according sex were conducted using the Kaplan-Meier method, the log-rank test, Cox models and a propensity score.</div><div>Results: 694 patients were included, of whom 130 (18.7 %) were women. Among them, 587 (86 %) had cirrhosis, mainly compensated (Child A 62.7 %), and related to alcohol (48.7 %), HCV (27.2 %), and/or metabolic-associated fatty liver disease (25.8 %). HCC was unifocal in 54 % of cases, with a mean main nodule size of 37 mm. Curative treatment was administered in 45.4 % of cases (percutaneous ablation 93 %). Compared to men, women diagnosed with HCC were older (73 vs. 65 years, p &lt; 0.001), were more frequently HCV-infected (40 % vs. 24 %, p = 0.0003) and presented more often with a solitary HCC (63 % vs. 52 %, p = 0.020). After a median follow-up of 57 months, overall survival was significantly longer in women both in multivariate analysis (aHR 1.39 (CI95 %: 1.07-1.81) p=0.014) and using a propensity score (HR 1.51 (1.13-2.02, p=0.005)).</div><div>Conclusion: Despite being diagnosed at an older age, women with HCC exhibit significant better overall survival.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"48 10","pages":"Article 102498"},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A review investigating delays in Crohn's disease diagnosis 研究克罗恩病诊断延误的综述。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-15 DOI: 10.1016/j.clinre.2024.102500
Christophe Souaid, Eddy Fares, Paul Primard, Gilles Macaigne, Weam El Hajj, Stephane Nahon
{"title":"A review investigating delays in Crohn's disease diagnosis","authors":"Christophe Souaid,&nbsp;Eddy Fares,&nbsp;Paul Primard,&nbsp;Gilles Macaigne,&nbsp;Weam El Hajj,&nbsp;Stephane Nahon","doi":"10.1016/j.clinre.2024.102500","DOIUrl":"10.1016/j.clinre.2024.102500","url":null,"abstract":"<div><div>Crohn's disease (CD) is a chronic inflammatory condition of the gastrointestinal tract where early diagnosis and timely, appropriate management are essential to prevent severe complications and reduce the need for surgery. This review sought to investigate factors contributing to diagnostic delays in CD, which typically ranged from 5 to 16 months. Delays were often due to nonspecific symptoms that could be mistaken for irritable bowel syndrome (IBS) and were influenced by various factors including age, education level, smoking, NSAID use, and disease characteristics like isolated ileal involvement. Healthcare system disparities also played a significant role, with delays varying by access to care. The review highlighted that delayed diagnosis was linked to worse disease outcomes, such as increased severity and complications, and underscored the importance of early intervention combined with timely management. Strategies to mitigate delays included implementing red flag tools, using inflammatory biomarkers like fecal calprotectin, and enhancing public and healthcare provider awareness. Addressing these factors and improving referral pathways and healthcare system efficiencies were crucial for enhancing early diagnosis and patient outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102500"},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Superiority of frailty over age in predicting outcomes among clostridium difficile patients: Evidence from national data 在预测梭状芽孢杆菌患者的预后方面,虚弱程度优于年龄:来自全国数据的证据。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-15 DOI: 10.1016/j.clinre.2024.102499
Ali Jaan , Umer Farooq , Abdulrahman Alyounes Alayoub , Hamna Nadeem , Effa Zahid , Ashish Dhawan , Savanna Thor , Asad Ur Rahman
{"title":"Superiority of frailty over age in predicting outcomes among clostridium difficile patients: Evidence from national data","authors":"Ali Jaan ,&nbsp;Umer Farooq ,&nbsp;Abdulrahman Alyounes Alayoub ,&nbsp;Hamna Nadeem ,&nbsp;Effa Zahid ,&nbsp;Ashish Dhawan ,&nbsp;Savanna Thor ,&nbsp;Asad Ur Rahman","doi":"10.1016/j.clinre.2024.102499","DOIUrl":"10.1016/j.clinre.2024.102499","url":null,"abstract":"<div><h3>Background</h3><div>Clostridium difficile infection (CDI) has become a significant healthcare issue with increasing morbidity and mortality in the US and Europe. Frailty, characterized by reduced physical reserves and resistance to stressors, is linked to poor outcomes but its impact on CDI patients remains underexplored. This study seeks to address this gap through a nationwide analysis.</div></div><div><h3>Methods</h3><div>Using the National Readmission Database from 2016 to 2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications codes to identify adult patients admitted with CDI. We further stratified CDI hospitalizations based on frailty. Utilizing a regression model, we assessed the impact of frailty on CDI outcomes.</div></div><div><h3>Results</h3><div>We included 144,611 CDI patients of whom 98,167 (67.88 %) were frail. Multivariate analysis showed that frail CDI patients had significantly higher mortality (adjusted odds ratio (aOR) 4.87), acute kidney injury requiring dialysis (aOR 9.50), septic shock (aOR 14.23), and intensive care unit admission (aOR 6.80). CDI-specific complications were more likely in frail patients, including toxic megacolon (aOR 10.22), intestinal perforation (aOR 2.30), need for colectomy (aOR 3.90) and CDI recurrence (aOR 3.65). Resource utilization, indicated by hospitalization charges, length of stay, and 30-day readmission rates, was greater among frail patients.</div></div><div><h3>Conclusion</h3><div>Our study underscores the significant association between frailty and various critical endpoints of CDI, including its incidence, mortality, and recurrence. Additionally, frailty independently predicts higher resource utilization and elevated 30-day readmission. Recognizing frailty as a determinant of CDI outcomes can aid clinicians in risk stratification and guide tailored interventions for this population.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102499"},"PeriodicalIF":2.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intra- and inter-patient diversity in hepatocellular carcinoma based on phosphorylation profiles—A pilot study in a single institution 基于磷酸化图谱的肝细胞癌患者内部和患者之间的多样性--在一家机构进行的试点研究。
IF 2.6 4区 医学
Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-15 DOI: 10.1016/j.clinre.2024.102497
Kan Toriguchi , Etsuro Hatano , Makoto Sudo , Ikuo Nakamura , Seiko Hirono
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