Gastroenterology Research最新文献

{"title":"Development of a Predictive Model for Common Bile Duct Stones in Patients With Clinical Suspicion of Choledocholithiasis: A Cohort Study.","authors":"Suppadech Tunruttanakul,&nbsp;Kotchakorn Verasmith,&nbsp;Jayanton Patumanond,&nbsp;Chatchai Mingmalairak","doi":"10.14740/gr1560","DOIUrl":"https://doi.org/10.14740/gr1560","url":null,"abstract":"<p><strong>Background: </strong>Current choledocholithiasis guidelines heavily focus on patients with low or no risk, they may be inappropriate for populations with high rates of choledocholithiasis. We aimed to develop a predictive scoring model for choledocholithiasis in patients with relevant clinical manifestations.</p><p><strong>Methods: </strong>A multivariable predictive model development study based on a retrospective cohort of patients with clinical suspicion of choledocholithiasis was used in this study. The setting was a 700-bed public tertiary hospital. Participants were patients who had completed three reference tests (endoscopic retrograde cholangiography, magnetic resonance cholangiopancreatography, and intraoperative cholangiography) from January 2019 to June 2021. The model was developed using logistic regression analysis. Predictor selection was conducted using a backward stepwise approach. Three risk groups were considered. Model performance was evaluated by area under the receiver operating characteristic curve, calibration, classification measures, and decision curve analyses.</p><p><strong>Results: </strong>Six hundred twenty-one patients were included; the choledocholithiasis prevalence was 59.9%. The predictors were age > 55 years, pancreatitis, cholangitis, cirrhosis, alkaline phosphatase level of 125 - 250 or > 250 U/L, total bilirubin level > 4 mg/dL, common bile duct size > 6 mm, and common bile duct stone detection. Pancreatitis and cirrhosis each had a negative score. The sum of scores was -4.5 to 28.5. Patients were categorized into three risk groups: low-intermediate (score ≤ 5), intermediate (score 5.5 - 14.5), and high (score ≥ 15). Positive likelihood ratios were 0.16 and 3.47 in the low-intermediate and high-risk groups, respectively. The model had an area under the receiver operating characteristic curve of 0.80 (95% confidence interval: 0.76, 0.83) and was well-calibrated; it exhibited better statistical suitability to the high-prevalence population, compared to current guidelines.</p><p><strong>Conclusions: </strong>Our scoring model had good predictive ability for choledocholithiasis in patients with relevant clinical manifestations. Consideration of other factors is necessary for clinical application, particularly regarding the availability of expert physicians and specialized equipment.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 5","pages":"240-252"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/be/78/gr-15-240.PMC9635785.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40717667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates, Reasons, and Independent Predictors of Readmissions in Portal Venous Thrombosis Hospitalizations in the USA.","authors":"Robert Kwei-Nsoro,&nbsp;Pius Ojemolon,&nbsp;Hisham Laswi,&nbsp;Ebehiwele Ebhohon,&nbsp;Abdultawab Shaka,&nbsp;Wasey Ali Mir,&nbsp;Abdul Hassan Siddiqui,&nbsp;Jobin Philipose,&nbsp;Hafeez Shaka","doi":"10.14740/gr1561","DOIUrl":"https://doi.org/10.14740/gr1561","url":null,"abstract":"<p><strong>Background: </strong>Portal vein thrombosis (PVT), generally considered rare, is becoming increasingly recognized with advanced imaging. Limited data exist regarding readmissions in PVT and its burden on the overall healthcare cost. This study aimed to outline the burden of PVT readmissions and identify the modifiable predictors of readmissions.</p><p><strong>Methods: </strong>The National Readmission Database (NRD) was used to identify PVT admissions from 2016 to 2019. Using the patient demographic and hospital-specific variables within the NRD, we grouped patient encounters into two cohorts, 30- and 90-day readmission cohorts. We assessed comorbidities using the validated Elixhauser comorbidity index. We obtained inpatient mortality rates, mean length of hospital stay (LOS), total hospital cost (THC), and causes of readmissions in both 30- and 90-day readmission cohorts. Using a multivariate Cox regression analysis, we identified the independent predictors of 30-day readmissions.</p><p><strong>Results: </strong>We identified 17,971 unique index hospitalizations, of which 2,971 (16.5%) were readmitted within 30 days. The top five causes of readmissions in both 30-day and 90-day readmission cohorts were PVT, sepsis, hepatocellular cancer, liver failure, and alcoholic liver cirrhosis. The following independent predictors of 30-day readmission were identified: discharge against medical advice (AMA) (adjusted hazard ratio (aHR) 1.86; P = 0.002); renal failure (aHR 1.44, P = 0.014), metastatic cancer (aHR 1.31, P = 0.016), fluid and electrolyte disorders (aHR 1.20, P = 0.004), diabetes mellitus (aHR 1.31, P = 0.001) and alcohol abuse (aHR 1.31, P ≤ 0.001).</p><p><strong>Conclusion: </strong>The readmission rate identified in this study was higher than the national average and targeted interventions addressing these factors may help reduce the overall health care costs.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 5","pages":"253-262"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2b/51/gr-15-253.PMC9635786.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40717663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult Intussusception in Chronic Marijuana Users.","authors":"Jiten P Kothadia,&nbsp;Anwesh Dash,&nbsp;Rajanshu Verma,&nbsp;Kyle Kreitman,&nbsp;Peter D Snell,&nbsp;Mohammad K Ismail","doi":"10.14740/gr1554","DOIUrl":"https://doi.org/10.14740/gr1554","url":null,"abstract":"<p><p>Intussusception is common in children, but it is rare in adults. The most common causes of adult intussusception (AI) are due to a pathological lead point with a common etiology being malignancy. Intra-luminal irritants should be considered the possible etiology of intussusception in patients without a pathological lead point. Marijuana use has increased dramatically in the United States over the last decade. With increasing public acceptance and legalization of marijuana, various adverse side effects have become more prominent. Marijuana has been shown to disrupt gastrointestinal tract motility by inhibiting cholinergic mechanisms. Here we describe four cases of AI who are chronic marijuana users. This well-referenced review gives attention to the harmful effects of marijuana, given the increasing use of marijuana and its derivatives in the United States.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 5","pages":"278-283"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/1f/gr-15-278.PMC9635787.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40717665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Percutaneous Endoscopic Gastrostomy Placement in Patients With SARS-CoV-2 Infection.","authors":"Ayushi Shah,&nbsp;Zunirah Ahmed,&nbsp;Fadl Zeineddine,&nbsp;Eamonn M M Quigley","doi":"10.14740/gr1533","DOIUrl":"https://doi.org/10.14740/gr1533","url":null,"abstract":"Background Coronavirus disease 2019 (COVID-19) can lead to ventilator-dependent chronic respiratory failure and a need for tube feeding. Percutaneous endoscopic gastrostomy (PEG) placement provides more sustainable longer-term enteral access with fewer side effects compared to the long-term nasogastric tube placement. Bleeding is a recognized complication of PEG placement, and many COVID-19 patients are on antiplatelets/anticoagulants, yet minimal data exist on the safety of PEG tube placement in this context. Methods A retrospective chart review identified patients who underwent PEG placement between January 2020 and January 2021 at a single institution. Success was defined as PEG placement and use to provide enteral nutrition with no complications requiring removal within 4 weeks. Results Thirty-six patients with and 104 age- and sex-matched patients without COVID-19 infection were included. More COVID-19 patients were obese, on anticoagulants, had low serum albumin levels and had a tracheostomy in place. Of those patients, 8.3% with COVID-19 developed PEG-related complications compared to 16.3% without (P = 0.28). PEG success rates in patients with and without COVID-19 were similar at 97.2% and 92.3%, respectively (P = 0.44). Conclusion PEG tube placement is comparatively safe in COVID-19 patients who need long-term enteral access.","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 5","pages":"263-267"},"PeriodicalIF":1.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/2b/gr-15-263.PMC9635784.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40717666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Pump Inhibitors Use and Increased Risk of Spontaneous Bacterial Peritonitis in Cirrhotic Patients: A Retrospective Cohort Analysis.","authors":"Loai Dahabra,&nbsp;Malek Kreidieh,&nbsp;Mohammad Abureesh,&nbsp;Ahmad Abou Yassine,&nbsp;Liliane Deeb","doi":"10.14740/gr1545","DOIUrl":"https://doi.org/10.14740/gr1545","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Since their introduction in the early 1980s, proton pump inhibitors (PPIs) have been used worldwide for a broad range of indications. Unfortunately, however, PPIs have become overly prescribed by healthcare providers, sometimes in the absence of clear indications. Although PPIs were initially presumed to have an excellent safety profile, emerging studies have shed light on the association between their long-term use and a myriad of side effects, including the possibility of an increased risk of spontaneous bacterial peritonitis (SBP). Data available to date regarding the association between PPI use and SBP development in cirrhotic patients is conflicting. While some observational studies provide no association between PPI use in cirrhotic patients and an increased risk of SBP development, many others support this association. As a result of the conflicting conclusions from case controls, cohorts, and meta-analyses, we aimed to carry out this retrospective cohort analysis of data from cirrhotic patients included in the electronic medical record-based commercial database, EXPLORYS (IMB-WATSON, Cleveland, Ohio). Our aim was to evaluate for a possible association between PPIs use and the risk of SBP development in cirrhotic patients and to compare the prevalence of SBP development between cirrhotic patients who were actively using PPIs and those who were not.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort analysis with chart review was conducted on patients with cirrhosis who were included in the electronic medical record-based commercial database, EXPLORYS (IMB-WATSON, Cleveland, Ohio). Using this database, records were reviewed between December 2017 and 2020. Included patients were adults aged 30 to 79 years with a Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) diagnosis of liver cirrhosis. Included patients with a SNOMED-CT diagnosis of liver cirrhosis were divided into two groups: the first group included all cirrhotic patients who did not use PPIs and the second group included all cirrhotic patients who were on PPIs at home.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In our analysis, SBP occurred in 1.7% (1,860 patients) of the included cirrhotic patients whether they were actively taking PPIs or not. Among the 40,670 cirrhotic patients who were on PPIs at home, 1,350 (3.3%) patients developed SBP. On multivariate analysis, PPI use was the strongest predictor for SBP in cirrhotic patients (odds ratio (OR) = 4.24; 95% confidence interval (CI): 3.83 - 4.7, P value &lt; 0.0001), with cirrhotic patients taking PPIs being 4.24 more likely to develop SBP than those not on PPIs. In addition, PPI use, history of bleeding varices, age, race, and gender were found to be independent predicting factors for SBP, in descending order of importance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our retrospective cohort analysis has shown that the use of PPIs in patients with liver cirrhosis is an independent predicting risk fac","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"180-187"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a2/f7/gr-15-180.PMC9451581.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Colonoscopy in Hospitalized Patients With Acute Lower Gastrointestinal Bleeding: A Nationwide Analysis.","authors":"Kuldeepsinh P Atodaria,&nbsp;Samyak Dhruv,&nbsp;Joseph M Bruno,&nbsp;Brisha Bhikadiya,&nbsp;Shravya R Ginnaram,&nbsp;Shreeja Shah","doi":"10.14740/gr1536","DOIUrl":"https://doi.org/10.14740/gr1536","url":null,"abstract":"<p><strong>Background: </strong>Performing colonoscopy within 24 h of presentation to the hospital is the accepted standard of care for patients with an acute lower gastrointestinal bleed (LGIB). Previous studies have failed to demonstrate the benefit of early colonoscopy (EC) on mortality. In this study, we wanted to see if there was a change in inpatient deaths (primary outcome), length of stay (LOS), and hospitalization charges (TOTCHG) (secondary outcomes) with EC compared to previous studies.</p><p><strong>Methods: </strong>Adults diagnosed with LGIB were identified using the International Classification of Disease 10th Revision codes from the National Inpatient Sample database for 2016 to 2019. EC was defined as the procedure performed within 24 h of hospitalization. Delayed colonoscopy (DC) was defined as a procedure performed after 24 h of presentation. The patient population was divided into EC and DC groups, and the effects of several covariates on outcomes were measured using binary logistic and multivariate regression analysis. Inverse probability treatment weighting (IPTW) was performed to adjust for confounding covariates.</p><p><strong>Results: </strong>There were 1,549,065 cases diagnosed with LGIB, of which 285,165 cases (18.4%) received a colonoscopy. A total of 107,045 (6.9%) patients received early colonoscopies. EC was associated with decreased inpatient deaths (0.9% in EC, and 1.4% in DC, P < 0.001). However, upon IPTW, this difference was not present. EC was associated with a decreased LOS (median 3 days vs. 5 days, P < 0.001) and TOTCHG (median $32,037 vs. $44,092, P < 0.001). Weekend admissions (WA) were associated with fewer EC (31.6% in WA, and 39.5% in non-WA, P < 0.001). WA did not affect inpatient deaths.</p><p><strong>Conclusions: </strong>EC was not associated with decreased inpatient deaths. There was no difference in endoscopic interventions in both EC and DC groups. The difference in inpatient deaths observed between the two groups was not evident upon adjusting the results for confounders. EC was associated with a decreased LOS, and TOTCHG in patients with LGIB.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"162-172"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/36/gr-15-162.PMC9451577.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of Alcohol Withdrawal Delirium in the Last Decade: Analysis of the Nationwide Inpatient Sample.","authors":"Hisham Laswi,&nbsp;Bashar Attar,&nbsp;Robert Kwei,&nbsp;Pius Ojemolon,&nbsp;Ebehiwele Ebhohon,&nbsp;Hafeez Shaka","doi":"10.14740/gr1550","DOIUrl":"https://doi.org/10.14740/gr1550","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder, high-risk drinking, and emergency visits for acute and chronic complications of alcohol use have been increasing in the USA recently. Approximately half of patients with alcohol use disorder experience alcohol withdrawal when they reduce or stop drinking. Though alcohol withdrawal is usually mild, 20% of patients experience more severe manifestations such as hallucinations, seizures, and delirium. In this study, we utilized the Nationwide Inpatient Sample to examine the trends of alcohol withdrawal delirium (AWD) in the period 2010 - 2019.</p><p><strong>Methods: </strong>This was a retrospective longitudinal trends study involving hospitalizations with AWD in the USA from 2010 to 2019. We searched the databases for hospitalizations using the International Classification of Diseases (ICD) codes (291.0 and F10231). We involved all hospitalizations complicated by AWD and hospitalizations with AWD as the principal diagnosis for admission. We excluded hospitalizations involving patients under the age of 18. We calculated the crude admission rate and the incidence of AWD per million adult hospitalizations during each calendar year. In addition, we analyzed trends of inpatient mortality, length of stay (LOS), and total hospital charges (THC).</p><p><strong>Results: </strong>The incidence of AWD per million hospitalizations increased from 2,671.8 in 2010 to 3,405.6 in 2019, with an annual percentage change (APC) of 3.1% (P < 0.001). Similarly, AWD admission rate per million hospitalizations increased from 1,030.3 in 2010 to 1,556.0 in 2019, with an average APC of 5.0% (P < 0.001). There were statistically significant trends of increasing inpatient mortality, THC, and LOS over the studied period. In general, female gender, younger age, and Black race were associated with better clinical outcomes.</p><p><strong>Conclusions: </strong>Our study showed an increase in the incidence and admission rates of AWD. Mortality, LOS, and THC increased over the studied period. Younger age, female gender, and Black race were associated with better clinical outcomes.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"207-216"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/86/gr-15-207.PMC9451584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Safety of the Re-Opening of an Academic Medical Center Outpatient Endoscopy Unit During the COVID-19 Pandemic.","authors":"Scott Manski,&nbsp;Christopher J Schmoyer,&nbsp;Alice Pang,&nbsp;Joshua Lieberman,&nbsp;Micaela Gernhardt,&nbsp;Elizabeth Conn,&nbsp;Neveda Murugesan,&nbsp;Alexandra Leto,&nbsp;Ryan Erwin,&nbsp;Taylor Kavanagh,&nbsp;Mitchell Conn","doi":"10.14740/gr1551","DOIUrl":"https://doi.org/10.14740/gr1551","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has spread globally leading to over 3,700,000 deaths. As COVID-19 cases stabilized, the re-opening of endoscopy centers potentially exposed patients and healthcare workers to viral infection. This study aims to determine risk of COVID-19 exposure among patients undergoing outpatient endoscopies in a tertiary care setting during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Patients undergoing outpatient endoscopy were contacted post-procedure for any new COVID-19 symptoms or COVID-19 test results. Patient experiences and perception of personal safety were also determined.</p><p><strong>Results: </strong>Of the 1,584 patients who completed elective endoscopy, 996 (62.9%) completed the survey. Two patients were diagnosed with COVID-19 within 14 days of procedure. The majority (99.7%) felt safe during their procedure and apprehension regarding endoscopy decreased over time.</p><p><strong>Conclusion: </strong>Thus, the risk of COVID-19 transmission during outpatient endoscopy is extremely low when following recommended society guidelines. Patients felt safe during the procedure and experienced less fear of exposure over time.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"200-206"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/c5/gr-15-200.PMC9451579.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Gastroesophageal Reflux Disease and Non-Small Cell Lung Cancer: A Retrospective Case-Control Study.","authors":"Shivantha Amarnath,&nbsp;Adam Starr,&nbsp;Divya Chukkalore,&nbsp;Ahmed Elfiky,&nbsp;Mohammad Abureesh,&nbsp;Anum Aqsa,&nbsp;Chetan Singh,&nbsp;Chanudi Weerasinghe,&nbsp;Dhineshreddy Gurala,&nbsp;Seleshi Demissie,&nbsp;Liliane Deeb,&nbsp;Terenig Terjanian","doi":"10.14740/gr1537","DOIUrl":"https://doi.org/10.14740/gr1537","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is a leading cause of mortality in the USA. Non-small cell lung cancer (NSCLC) contributes to 85% of all lung cancers. It is the most prevalent subtype amongst non-smokers, and its incidence has risen in the last 20 years. In addition, gastroesophageal reflux disease (GERD) has been associated with several lung pathologies, namely idiopathic pulmonary fibrosis and asthma. We aimed to investigate the association between GERD and NSCLC by performing a retrospective, multicenter, case-control study. This is the first study of this nature to be carried out in the USA.</p><p><strong>Methods: </strong>Data were retrieved from 17 Northwell health care facilities in the New York area between the years 2010 and 2018. Inclusion criteria were patients > 18 years of age with NSCLC (large cell, adenocarcinoma, and squamous cell). They were appropriately matched with controls based on age, gender, weight, comorbidities, and medication use. Our exposure group had a diagnosis of GERD based on the International Classification of Diseases, Ninth/10th Revision (ICD 9/10) codes and endoscopic, in addition to histological evidence if present. We excluded patients with secondary lung cancers, esophageal adenocarcinoma, other primary malignancies, Barrett's esophagus, and smokers. Logistic regression was conducted to determine the adjusted odds ratio (OR) and corresponding 95% confidence interval (CI) for the association between NSCLC and GERD.</p><p><strong>Results: </strong>A total of 1,083 subjects were included in our study: 543 (50%) patients were diagnosed with NSCLC. In this population, GERD was twice as prevalent compared to controls (20.4% vs. 11.6%, P < 0.001). Multivariate analysis demonstrated that GERD was associated with a higher risk of NSCLC compared to matched controls (OR = 1.86, 95% CI = 1.26 - 2.73). In addition, GERD patients treated with either antihistamines or proton pump inhibitors did not demonstrate an overall reduced risk of NSCLC (OR = 1.01, 95% CI = 0.48 - 2.12).</p><p><strong>Conclusions: </strong>Our study demonstrates that GERD is associated with a higher risk of NSCLC, irrespective of GERD treatment. We postulate that GERD patients suffer from chronic micro-aspirations leading to a prolonged inflammatory state within the lung parenchyma, triggering specific proliferative signaling pathways that may lead to malignant transformation.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"173-179"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/e2/gr-15-173.PMC9451582.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmissions After Biliary Acute Pancreatitis: Analysis of the Nationwide Readmissions Database.","authors":"Hisham Laswi,&nbsp;Bashar Attar,&nbsp;Robert Kwei,&nbsp;Michelle Ishaya,&nbsp;Pius Ojemolon,&nbsp;Bashar Natour,&nbsp;Mohammad Darweesh,&nbsp;Hafeez Shaka","doi":"10.14740/gr1548","DOIUrl":"https://doi.org/10.14740/gr1548","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis is a common inflammatory condition that involves the pancreas. Gallstones and alcohol are the most common etiologies in the USA. Cholecystectomy is the cornerstone procedure in the management of biliary acute pancreatitis (BAP). In this study, we examined the causes and predictors of readmissions following BAP based on the procedure performed.</p><p><strong>Methods: </strong>Using the Nationwide Readmissions Database (NRD) and the International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD10-CM/PCS), we retrospectively studied BAP hospitalizations (2016 - 2018). The first hospitalization within the year was marked as index hospitalization. Index hospitalizations were categorized based on whether an endoscopic retrograde cholangiopancreatography (ERCP) and/or a cholecystectomy was performed into no procedure group, ERCP group, cholecystectomy group, and both procedures group. We subsequently identified readmissions within 30 days. Using this categorization, we studied reasons, rates, and predictors of readmissions.</p><p><strong>Results: </strong>A total of 127,318 index hospitalizations were included. The cholecystectomy group constituted the largest share of this cohort (43.5%). Using the no procedure group as a reference, analysis of the outcomes showed that the cholecystectomy group had the lowest inpatient mortality (adjusted odds ratio (aOR): 0.18, P < 0.001), while both procedures group had the highest total hospital charges (adjusted mean difference (aMD): 42,249, P < 0.001). Acute pancreatitis without necrosis or infection was the most frequent principal diagnosis for readmission (18.7%). Analysis of readmission predictors showed that both procedures group had the lowest risk for readmission (adjusted hazard ratio (aHR): 0.40, P < 0.001). Females were less likely to be readmitted compared to males (aHR: 0.82, P < 0.001) and elderly were less likely to be readmitted compared to young adults (aHR: 0.82, P < 0.001). Patients discharged against medical advice were more likely to be readmitted (aHR: 1.76, P < 0.001).</p><p><strong>Conclusion: </strong>Undergoing both ERCP and cholecystectomy for BAP resulted in significantly higher hospital charges with no additional mortality benefit. However, it decreased the readmission risk significantly. Acute pancreatitis without necrosis or infection was the most frequent reason for readmissions.</p>","PeriodicalId":12461,"journal":{"name":"Gastroenterology Research","volume":"15 4","pages":"188-199"},"PeriodicalIF":1.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/02/gr-15-188.PMC9451580.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}