重度食管炎患者的量身定制随访内镜检查

IF 2.4 Q3 GASTROENTEROLOGY & HEPATOLOGY
Rebecca K Grant, William M Brindle, Caitlyn L Taylor, Edward J Rycroft, Oluwadara Oyewole, Sarah C Morgan, Eleanor F Watson, Atul Anand, Norma C McAvoy, Ian D Penman, Nicholas I Church, Kenneth C Trimble, Colin L Noble, John N Plevris, Gail S M Masterton, Rahul Kalla
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引用次数: 0

摘要

目的通过评估Barrett食管(BO)、肿瘤、发育不良和狭窄的发生率,探讨重度食管炎(洛杉矶分级C级或D级)患者随访食管胃十二指肠镜(OGD2)的临床应用价值。其次,我们的目的是确定临床虚弱量表(CFS)是否可以用于确定接受OGD2s的患者。设计/方法选取2014年1月1日至2015年12月31日期间在洛锡安NHS诊断为OGD1指数(OGD1)的严重食管炎患者。单因素分析确定了与成绩相关的因素。患者根据虚弱程度和狭窄、癌症、发育不良和BO的诊断进行分层。结果重度食管炎964例,其中C级61.7%,d级38.3%。OGD2新发病理诊断率为13.2%(51例),新发狭窄(2.3%),发育不良(0.5%),癌(0.3%),BO(10.1%)。共有140例患者出现临床虚弱(CFS评分≥5),其中88.6%的患者在回顾时死亡(中位为76个月)。共有16.4%的体弱患者接受了OGD2s治疗,并诊断出5种新的病理,但没有一种与分级显著相关。在OGD2的非虚弱患者中,BO是d级患者中唯一更常见的病理(p=0.010)。癌症、发育不良和狭窄的发生率在不同级别之间没有显著差异。结论我们的数据表明,严重食管炎患者的OGD2s可根据临床虚弱度量身定制,仅适用于非虚弱患者。在非虚弱的患者中,OGD2s在两级严重食管炎的险恶病理中有相似的上升率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tailoring follow-up endoscopy in patients with severe oesophagitis
Objective We aimed to investigate the clinical utility of follow-up oesophagogastroduodenoscopy (OGD2) in patients with severe oesophagitis (Los Angeles grades C or D) through evaluating the yield of Barrett’s oesophagus (BO), cancer, dysplasia and strictures. Second, we aimed to determine if the Clinical Frailty Scale (CFS) may be used to identify patients to undergo OGD2s. Design/method Patients in NHS Lothian with an index OGD (OGD1) diagnosis of severe oesophagitis between 1 January 2014 and 31 December 2015 were identified. Univariate analysis identified factors associated with grade. Patients were stratified by frailty and a diagnosis of stricture, cancer, dysplasia and BO. Results In total 964 patients were diagnosed with severe oesophagitis, 61.7% grade C and 38.3% grade D. The diagnostic yield of new pathology at OGD2 was 13.2% (n=51), new strictures (2.3%), dysplasia (0.5%), cancer (0.3%) and BO (10.1%). A total of 140 patients had clinical frailty (CFS score ≥5), 88.6% of which were deceased at review (median of 76 months). In total 16.4% of frail patients underwent OGD2s and five new pathologies were diagnosed, none of which were significantly associated with grade. Among non-frail patients at OGD2, BO was the only pathology more common (p=0.010) in patients with grade D. Rates of cancer, dysplasia and strictures did not vary significantly between grades. Conclusion Our data demonstrate that OGD2s in patients with severe oesophagitis may be tailored according to clinical frailty and only be offered to non-frail patients. In non-frail patients OGD2s have similar pick-up rates of sinister pathology in both grades of severe oesophagitis.
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来源期刊
Frontline Gastroenterology
Frontline Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.70
自引率
11.50%
发文量
93
期刊介绍: Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology and hepatology. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. Specifically Frontline Gastroenterology publishes articles in the domains of clinical quality, patient experience, service provision and medical education.
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