The American journal of the medical sciences最新文献_第4页

CT-based body composition parameters predict the loss of response to infliximab in patients with Crohn's disease. 基于 CT 的身体成分参数可预测克罗恩病患者对英夫利西单抗失去反应。

The American journal of the medical sciences Pub Date : 2024-09-03 DOI: 10.1016/j.amjms.2024.08.025

Shaotang Li, Hao Wu, Shouliang Miao, Chen Huang, Yini Zhang, Xinyi Shao, Chao Chen, Xiaoli Wu

{"title":"CT-based body composition parameters predict the loss of response to infliximab in patients with Crohn's disease.","authors":"Shaotang Li, Hao Wu, Shouliang Miao, Chen Huang, Yini Zhang, Xinyi Shao, Chao Chen, Xiaoli Wu","doi":"10.1016/j.amjms.2024.08.025","DOIUrl":"10.1016/j.amjms.2024.08.025","url":null,"abstract":"Objective: Infliximab is a first-line biologic agent for the treatment of Crohn's disease (CD), in which loss of response (LOR) remains a challenge in the treatment of patients with CD. The study aimed to explore the association between body composition parameters and LOR to infliximab in CD patients.Methods: 118 patients with CD admitted to the First Affiliated Hospital of Wenzhou Medical University and treated with infliximab from June 2015 to December 2021 were retrospectively enrolled. The body composition of patients was analyzed by computed tomography (CT). The primary outcome measure was the one-year LOR. Patients were divided into the Remission group and the LOR group to analyze the association between body composition parameters and the LOR to infliximab.Results: The rate of sarcopenia in the LOR group was higher than in the Remission group (83.7% vs. 60.0%, P=0.008). Multivariate analysis showed that females had a lower risk of sarcopenia than males (OR=0.30, 95% CI 0.11-0.81, P =0.017); BMI was significantly associated with sarcopenia (OR=0.68, 95% CI 0.56-0.83, P <0.001); L1 CD and L2 CD had a lower risk of sarcopenia than L3 CD (OR=0.29, 95% CI 0.10-0.83, P =0.021; OR=0.25, 95% CI 0.07-0.87, P=0.028).Conclusions: Sarcopenia was identified as a risk factor for developing LOR in infliximab-treated patients.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New onset diabetic ketoacidosis in a renal transplant recipient. 肾移植受者新发糖尿病酮症酸中毒

The American journal of the medical sciences Pub Date : 2024-08-29 DOI: 10.1016/j.amjms.2024.08.023

Havird McLean Skalak, Kaitlyn Haas, Melissa Laub, Laura L Mulloy

{"title":"New onset diabetic ketoacidosis in a renal transplant recipient.","authors":"Havird McLean Skalak, Kaitlyn Haas, Melissa Laub, Laura L Mulloy","doi":"10.1016/j.amjms.2024.08.023","DOIUrl":"10.1016/j.amjms.2024.08.023","url":null,"abstract":"Post-transplant diabetes mellitus (PTDM) is a well-known solid organ transplant complication, which can be related to immunosuppressants, particularly tacrolimus. We report an unusual presentation of PTDM with diabetic ketoacidosis (DKA). This is unique as PTDM typically resembles Type 2 DM, whereas DKA is associated with Type 1 DM and has rarely been reported as a complication of tacrolimus. A 38-year-old African American male on LCP-tacrolimus presented four months post kidney transplant with vomiting, weakness, poor appetite, and polyuria. Labs demonstrated hyperglycemia, ketonuria, and high anion gap metabolic acidosis. He was nonobese and had no personal or family history of Type 2 DM. DKA was suspected to be secondary to tacrolimus-induced pancreatic beta cell damage worsened by supratherapeutic tacrolimus levels. Latent autoimmune diabetes in adults (LADA) was diagnosed when further testing showed insulinopenia, low C-peptide, and anti-glutamic acid decarboxylase (GAD) autoantibodies. He required 120-units of subcutaneous insulin daily. Our literature review revealed only 16 other tacrolimus-induced DKA cases. No cases reported anti-GAD positivity and most showed beta cell toxicity reversibility with tacrolimus tapering or substitution. Our patient was early post-transplant with leukocytopenia, so tacrolimus was not exchanged. This unusual PTDM case may have resulted from both autoimmune and tacrolimus-induced beta cell destruction. Physicians should be aware of new onset LADA post-transplantation and tacrolimus toxicity leading to DKA, even in patients without traditional risk factors. Anti-GAD antibody screening in patients on tacrolimus who develop PTDM may identify patients less likely to recover beta cell function with immunosuppression augmentation which requires careful monitoring.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medication-induced fractures: Screening and treatment strategies. 药物诱发骨折：筛查和治疗策略。

The American journal of the medical sciences Pub Date : 2024-08-28 DOI: 10.1016/j.amjms.2024.08.024

Laraib Javed, Aemen Khakwani, Uzair Khan, Mary Beth Humphrey

引用次数: 0

Cardiovascular risk factors for the diagnosis of insomnia in end-stage renal disease. 诊断终末期肾病患者失眠症的心血管风险因素。

The American journal of the medical sciences Pub Date : 2024-08-27 DOI: 10.1016/j.amjms.2024.08.022

Kiana Kim, Katlyn Smaha, Jennifer L Waller, Wendy B Bollag, Stephanie L Baer, Varsha Taskar, Vishal Arora, William J Healy

{"title":"Cardiovascular risk factors for the diagnosis of insomnia in end-stage renal disease.","authors":"Kiana Kim, Katlyn Smaha, Jennifer L Waller, Wendy B Bollag, Stephanie L Baer, Varsha Taskar, Vishal Arora, William J Healy","doi":"10.1016/j.amjms.2024.08.022","DOIUrl":"10.1016/j.amjms.2024.08.022","url":null,"abstract":"Background: Insomnia, a known cardiovascular risk factor, is common in end-stage renal disease (ESRD) patients. There is growing acknowledgment of a potential bidirectional relationship between cardiovascular diseases and sleep disorders. We previously assessed the risk factors for common sleep disorders in ESRD patients. This follow-up study assesses the demographic and clinical cardiovascular-related risk factors for insomnia diagnosis in ESRD patients, given their increased cardiovascular burden.Methods: This study is a retrospective analysis of the United States Renal Data System to evaluate risk factors for insomnia diagnosis. All patients in the USRDS who started dialysis between 2005 and 2019 were eligible for inclusion. Demographic risk factors analyzed were age, race, sex, ethnicity, dialysis modality, and access type. Cardiovascular risk factors, including obstructive sleep apnea (OSA) and central sleep apnea (CSA), were also evaluated.Results: Female sex, OSA, CSA, myocardial infarction, congestive heart failure, peripheral vascular disease, cerebrovascular disease, diabetes, chronic obstructive pulmonary disease, obesity, and hypertension were associated with an increased risk of insomnia. Increasing age, non-white race, Hispanic ethnicity, and catheter or other/peritoneal dialysis access type were associated with a decreased risk of an insomnia diagnosis.Conclusion: Various cardiovascular diseases were independent risk factors for an insomnia diagnosis in this retrospective cohort. Further study is indicated to investigate potential mechanisms underlying this connection.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between cardiovascular health and serum vitamin D and its interaction with prediabetes and diabetes. 心血管健康与血清维生素 D 之间的关系及其与糖尿病前期和糖尿病的相互作用。

The American journal of the medical sciences Pub Date : 2024-08-24 DOI: 10.1016/j.amjms.2024.08.021

Ying Chen, Haiyu Zhang, Yanbing Pan, Yanzi Zhang, Yuxuan Yang, Lu Liu, Qiuting Jia, Yongle Wang, Yihui Kong

{"title":"Association between cardiovascular health and serum vitamin D and its interaction with prediabetes and diabetes.","authors":"Ying Chen, Haiyu Zhang, Yanbing Pan, Yanzi Zhang, Yuxuan Yang, Lu Liu, Qiuting Jia, Yongle Wang, Yihui Kong","doi":"10.1016/j.amjms.2024.08.021","DOIUrl":"10.1016/j.amjms.2024.08.021","url":null,"abstract":"Background: Prediabetes and diabetes are common and serious public health problems, and high blood glucose can lead to serious cardiovascular complications. The purpose of this article was to explore the link between CVH levels and the incidence of prediabetes and diabetes in people over 20 years old, and whether serum vitamin D status could alter this relationship.Materials and methods: Data, from six consecutive cycles of the NHANES database from 2007 to 2018 were combined, eligible participants were aged ≥20 years. After excluding missing data, a total of 19,992 subjects were enrolled in the study. Significant risk factors for prediabetes and diabetes were analyzed using univariate and multivariate logistic regression. Exploring the interaction of VD and CVH on prediabetes and diabetes based on multifactorial regression analysis.Results: The prevalence of prediabetes among all participants was 36.15% and the prevalence of diabetes was 16.39%. CVH and vitamin D levels are influential factors in prediabetes and diabetes, and are negatively associated with the risk of developing prediabetes and diabetes. Compared with normoglycemia, poorer CVH and vitamin D deficiency only had a synergistic multiplicative interaction on the development of diabetes, and no significant interaction was observed for the development of prediabetes. Compared with prediabetes, poorer CVH and vitamin D deficiency still had a synergistic additive interaction on the development of diabetes.Conclusions: Although the cross-sectional study only determine the association and do not prove causality, the current results can be used to prompt people to improve their lifestyle and risk factors to prevent prediabetes or diabetes through higher CVH and adequate Vitamin D.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Useful biomarkers for predicting poor prognosis of patients with drug-induced liver injury: A retrospective cohort study. 预测药物性肝损伤患者不良预后的有用生物标志物：一项回顾性队列研究

The American journal of the medical sciences Pub Date : 2024-08-23 DOI: 10.1016/j.amjms.2024.08.019

Hsueh-Chien Chiang, I-Chin Wu

{"title":"Useful biomarkers for predicting poor prognosis of patients with drug-induced liver injury: A retrospective cohort study.","authors":"Hsueh-Chien Chiang, I-Chin Wu","doi":"10.1016/j.amjms.2024.08.019","DOIUrl":"10.1016/j.amjms.2024.08.019","url":null,"abstract":"Background: Drug-induced liver injury (DILI) plays an important role in liver failure and causes mortality. Patients with DILI compatible with Hy's law are associated with poorer outcomes. However, the predictive accuracy of Hy's law is not good enough in clinical practice. This study aimed to investigate the optimal values of biomarkers associated with the prognosis of DILI.Methods: From June 1, 2014-May 30, 2022, patients with reported DILI were included. Patients' characteristics, drugs, DILI type, liver enzymes, and comorbidities were assessed. The associations with DILI-related comorbidities and survival were analyzed.Results: Ninety-five DILI patients were enrolled, 5 patients died of liver failure, and 23 patients died within 56 weeks after DILI. This study found that 15 mg/dL of total bilirubin, 1000 U/L of ALT, and 2 of PT-INR were optimal cut-off values in predicting DILI-related mortality. For the overall survival, patients with sepsis (HR:5.053, 95% CI:1.594-16.018, p = 0.006), malignancy (HR:4.371, 95% CI:1.573-12.147, p = 0.005), or end-stage renal disease (HR:7.409, 95% CI:1.404-39.103, p = 0.018) were independent poor prognostic factors in multivariate Cox regression analysis.Conclusions: Total bilirubin >15 mg/dL, ALT >1000 U/L, and PT-INR >2 are useful biomarkers in predicting DILI-related mortality. DILI patients with sepsis, malignancy, or end-stage renal disease are associated with worse overall survival.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

1,25-dihydroxyvitamin D mediated hypercalcemia in seminoma. 精原细胞瘤中由 1,25-二羟维生素 D 介导的高钙血症

The American journal of the medical sciences Pub Date : 2024-08-22 DOI: 10.1016/j.amjms.2024.08.015

Julianna Sim, Jonathan Irvin, Nezam Altorok

{"title":"1,25-dihydroxyvitamin D mediated hypercalcemia in seminoma.","authors":"Julianna Sim, Jonathan Irvin, Nezam Altorok","doi":"10.1016/j.amjms.2024.08.015","DOIUrl":"10.1016/j.amjms.2024.08.015","url":null,"abstract":"Hypercalcemia has rarely been associated with seminomas. Due to the limited data available, the pathophysiology of hypercalcemia in seminoma has not been established in literature. We present a case of a 59-year-old male who presented with weakness, abdominal fullness, fatigue, constipation, and a 14 lb unintentional weight loss. On initial presentation he was found to be hypercalcemia with calcium of 16.2 mg/dL (normal 8.6-10.3 mg/dL). Subsequently, a metastatic seminoma was discovered with no evidence of bony metastasis. 1,25-dihydroxyvitamin D was elevated at >200 pg/mL (reference 19.9-79.3 pg/mL). PTH was suppressed at 11 pg/mL (reference 12-88 pg/mL). PTHrP was normal at 1.0 pmol/L (reference ≤4.2 pmol/L), 25‑hydroxy vitamin D was low at 22.6 ng/mL (reference 30-100 ng/mL), and phosphorus was normal at 3.9 mg/dL (reference 2.4-4.9 mg/dL). These findings indicate 1,25-dihydroxyvitamin D mediated hypercalcemia of malignancy. Hypercalcemia in seminoma has been reported in 11 cases, that we review in this report. However, few cases present sufficient data to conclude the pathophysiology of hypercalcemia. In all four cases that presented 1,25-hydroxyvitamin D levels, the levels were elevated, suggesting seminomas are associated with 1,25-hydroxyvitamin D mediated hypercalcemia. Interestingly, one case was associated with increased 1,25-hydroxyvitamin D and increased PTHrP levels, suggesting there may be multiple mechanisms of hypercalcemia in seminomas.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of mean heart rate on 30-day mortality in older patients with sepsis: Data from the MIMIC-IV database. 平均心率对老年败血症患者 30 天死亡率的影响：来自 MIMIC-IV 数据库的数据。

The American journal of the medical sciences Pub Date : 2024-08-21 DOI: 10.1016/j.amjms.2024.08.006

Qiang Zhou, Jianing Li, Yuxiu Miao, Na Li

{"title":"Effect of mean heart rate on 30-day mortality in older patients with sepsis: Data from the MIMIC-IV database.","authors":"Qiang Zhou, Jianing Li, Yuxiu Miao, Na Li","doi":"10.1016/j.amjms.2024.08.006","DOIUrl":"10.1016/j.amjms.2024.08.006","url":null,"abstract":"Background: Sepsis is a critical condition with a significant risk of mortality. Advanced age is one factor in increasing mortality in intensive care.Objectives: The aim of this study is to investigate the association between mean heart rate (MHR) and 30-day mortality among older patients with sepsis in the intensive care unit (ICU).Methods: All older patients (age 65 or older) with sepsis for first time in ICU admission in Medical Information Mart for Intensive Care-IV (MIMIC-IV) were included in this retrospective study. The effect of MHR within 24 h of ICU admission on 30-day mortality was assessed according to multivariable Cox regression models, restricted cubic splines and two-piecewise Cox regression models.Results: The total number of participants was 6598 (mean heart rate, 83.8 ± 14.3 bpm). A total of 1295 (19.6%) patients died within 30 days after ICU admission. MHR within 24 h of admission was associated with 30-day mortality (J-shaped association) in older patients with sepsis in the ICU, with an inflection point at about 74 bpm and a minimal risk observed at 73 to 82 bpm of MHR.Conclusions: In this retrospective cohort study, there was a J-shaped association between MHR and 30-day mortality in older patients with sepsis admitted to the ICU and a minimal risk observed at 73 to 82 bpm of MHR. If further confirmed, this association may provide a theoretical basis for formulating the target strategy of heart rate therapy for these patients.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

FOXO4 suppresses cisplatin resistance of triple-negative breast cancer by inhibiting autophagy. FOXO4 通过抑制自噬抑制三阴性乳腺癌的顺铂耐药性

The American journal of the medical sciences Pub Date : 2024-08-21 DOI: 10.1016/j.amjms.2024.08.012

Yating Zhu, Chenguang Zhang, Qiuyu Yin, Wenting Xu, Yulou Luo, Jianghua Ou

{"title":"FOXO4 suppresses cisplatin resistance of triple-negative breast cancer by inhibiting autophagy.","authors":"Yating Zhu, Chenguang Zhang, Qiuyu Yin, Wenting Xu, Yulou Luo, Jianghua Ou","doi":"10.1016/j.amjms.2024.08.012","DOIUrl":"10.1016/j.amjms.2024.08.012","url":null,"abstract":"Background: Resistance to chemotherapy containing cisplatin (DDP) is a main challenge in the treatment of triple-negative breast cancer (TNBC). Forkhead box O4 (FOXO4) is frequently downregulated in DDP-resistant cells. However, it is unclear whether FOXO4 down-regulation is related to DDP resistance. Here, we investigated the relationship between FOXO4 and DDP resistance in TNBC.Methods: We established the DDP-resistant cell lines MDA-MB-231/DDP and BT-549/DDP through in vitro selection. CCK-8 and colony formation assays analyzed cell growth. The resistance index was calculated. Cell autophagy was evaluated. Western blotting and qRT-PCR measured protein and gene expression. The binding between FOXO4 and TGF-β1 was determined by the dual-luciferase reporter assay.Results: FOXO4 expression was significantly lower in MDA-MB-231/DDP and BT-549/DDP cells. FOXO4 overexpression increased the sensitivity of TNBC cells to DDP. The PI3K class Ⅲ and Beclin-1 levels and LC3-II/LC3-I ratio elevated significantly in DDP-resistant cells. Moreover, the autophagic flux was enhanced in DDP-resistant cells. 3-MA enhanced the sensitivity of TNBC cells to DDP by inhibiting autophagy. Overexpression of FOXO4, treatment with 3-MA, and their combination significantly reduced the drug resistance index. FOXO4 directly targeted TGF-β1. Additionally, TGF-β1 knockdown inhibited autophagy and restored the sensitivity of DDP-resistant cells to DDP. Mechanistically, FOXO4 affected TNBC resistance to DDP by regulating autophagy and TGF-β1.Conclusion: FOXO4 overexpression, in combination with autophagy inhibitors, can significantly improve the sensitivity of TNBC-resistant cells to DDP. These findings reveal the role and mechanism of FOXO4 in DDP sensitivity and may provide evidence for the development of TNBC therapies.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating outcomes of transjugular intrahepatic portosystemic shunt procedure among Native Americans. 评估美国原住民经颈静脉肝内门体分流术的效果。

The American journal of the medical sciences Pub Date : 2024-08-21 DOI: 10.1016/j.amjms.2024.08.008

Renxi Li, Shawn Sarin

{"title":"Evaluating outcomes of transjugular intrahepatic portosystemic shunt procedure among Native Americans.","authors":"Renxi Li, Shawn Sarin","doi":"10.1016/j.amjms.2024.08.008","DOIUrl":"10.1016/j.amjms.2024.08.008","url":null,"abstract":"Background: This study aims to explore racial disparities in immediate outcomes of Transjugular Intrahepatic Portosystemic Shunt (TIPS) among Native Americans, a group that have higher prevalence of liver cirrhosis but were the \"invisible group\" in previous TIPS studies due to their small population size.Methods: The study identified Native Americans and Caucasians who underwent TIPS in National/Nationwide Inpatient Sample (NIS) database from Q4 2015-2020. Preoperative factors, including demographics, indications for TIPS, comorbidities, etiologies for liver disease, primary payer status, and hospital characteristics, were matched by 1:5 propensity score matching. In-hospital post-TIPS outcomes were then compared between the two cohorts.Results: There were 6,658 patients who underwent TIPS, where 101 (1.52%) were Native Americans and 4,574 (68.70%) were Caucasians. Native Americans presented as younger, with a lower socioeconomic status, and displayed higher rates of alcohol abuse and related liver diseases. After propensity-score matching, Native Americans had comparable in-hospital post-TIPS outcomes including mortality (8.33% vs 9.09%, p = 1.00), hepatic encephalopathy (18.75% vs 25.84%, p = 0.19), acute kidney injury (28.13% vs 30.62%, p = 0.71), and other adverse events. Native Americans also had similar wait from admission to operation (2.15 ± 0.30 vs 2.87 ± 0.21 days, p = 0.13), hospital length of stay (7.43 ± 0.63 vs 8.62 ± 0.47 days, p = 0.13), and total costs (158,299 ± 14,218.2 vs 169,425 ± 8,600.7 dollars, p = 0.50).Conclusion: Native Americans had similar immediate outcomes after TIPS compared to their propensity-matched Caucasians. While these results underscore effective healthcare delivery of TIPS to Native Americans, it is imperative to pursue further research for long-term post-procedure outcomes.","PeriodicalId":94223,"journal":{"name":"The American journal of the medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0