Saurabh Chandan , Rahul Karna , Aakash Desai , Babu P. Mohan , Dushyant Singh Dahiya , Daryl Ramai , Antonio Facciorusso , Mohammad Bilal , Douglas G. Adler , Gursimran S. Kochhar
{"title":"低体重指数 (LBMI) 与内镜检查相关不良事件的风险 - 一项美国队列倾向分数匹配研究","authors":"Saurabh Chandan , Rahul Karna , Aakash Desai , Babu P. Mohan , Dushyant Singh Dahiya , Daryl Ramai , Antonio Facciorusso , Mohammad Bilal , Douglas G. Adler , Gursimran S. Kochhar","doi":"10.1016/j.tige.2023.12.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and Aims</h3><p>Patients with a low body mass index (LBMI) are often encountered in routine outpatient gastrointestinal (GI) endoscopy practice, and the assessment of procedure-related risks in this subset of individuals remains paramount. Although the risk of endoscopy-related adverse events (AEs) has been reported in patients with obesity, the association between LBMI and AEs has not been established.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study using TriNetX, a multi-institutional database, to assess the risk of endoscopy-related AEs in patients with LBMI (<18.4 kg/m<sup>2</sup>) compared with patients with a nonobese body mass index (18.5-29.9 kg/m<sup>2</sup>) (control cohort) after low-risk outpatient diagnostic esophagogastroduodenoscopy (EGD), colonoscopy, or percutaneous endoscopic gastrostomy (PEG) tube placement. One-to-one (1:1) propensity score matching was performed. The primary endpoints were to assess the risk of GI bleeding, perforation, or aspiration pneumonia within 30 days. Risk was expressed as adjusted odds ratios (aORs) with 95% confidence intervals.</p></div><div><h3>Results</h3><p>A total of 28,677, 18,449, and 3076 patients with LBMI underwent EGD, colonoscopy, and PEG tube placement, respectively. After propensity score matching, compared with the control cohort, patients with LBMI undergoing EGD and colonoscopy with or without biopsies were at an increased risk for GI bleeding (aOR 1.36 and 2.21), perforation (aOR 1.96 and 2.65), and aspiration pneumonia (aOR 3.13 and 2.71), respectively. Additionally, patients in the LBMI PEG cohort were found to be at an increased risk for aspiration pneumonia (aOR 1.33).</p></div><div><h3>Conclusion</h3><p>Our study shows that, when compared with nonobese controls, patients with LBMI are at an increased risk of endoscopy-related AEs. Appropriate precautions must be considered while performing routine endoscopic procedures to offset these risks in such patients.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Low Body Mass Index and Risk of Endoscopy-Related Adverse Events: A United States Cohort Propensity Score—Matched Study\",\"authors\":\"Saurabh Chandan , Rahul Karna , Aakash Desai , Babu P. Mohan , Dushyant Singh Dahiya , Daryl Ramai , Antonio Facciorusso , Mohammad Bilal , Douglas G. Adler , Gursimran S. Kochhar\",\"doi\":\"10.1016/j.tige.2023.12.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and Aims</h3><p>Patients with a low body mass index (LBMI) are often encountered in routine outpatient gastrointestinal (GI) endoscopy practice, and the assessment of procedure-related risks in this subset of individuals remains paramount. Although the risk of endoscopy-related adverse events (AEs) has been reported in patients with obesity, the association between LBMI and AEs has not been established.</p></div><div><h3>Methods</h3><p>We conducted a retrospective cohort study using TriNetX, a multi-institutional database, to assess the risk of endoscopy-related AEs in patients with LBMI (<18.4 kg/m<sup>2</sup>) compared with patients with a nonobese body mass index (18.5-29.9 kg/m<sup>2</sup>) (control cohort) after low-risk outpatient diagnostic esophagogastroduodenoscopy (EGD), colonoscopy, or percutaneous endoscopic gastrostomy (PEG) tube placement. One-to-one (1:1) propensity score matching was performed. The primary endpoints were to assess the risk of GI bleeding, perforation, or aspiration pneumonia within 30 days. Risk was expressed as adjusted odds ratios (aORs) with 95% confidence intervals.</p></div><div><h3>Results</h3><p>A total of 28,677, 18,449, and 3076 patients with LBMI underwent EGD, colonoscopy, and PEG tube placement, respectively. After propensity score matching, compared with the control cohort, patients with LBMI undergoing EGD and colonoscopy with or without biopsies were at an increased risk for GI bleeding (aOR 1.36 and 2.21), perforation (aOR 1.96 and 2.65), and aspiration pneumonia (aOR 3.13 and 2.71), respectively. Additionally, patients in the LBMI PEG cohort were found to be at an increased risk for aspiration pneumonia (aOR 1.33).</p></div><div><h3>Conclusion</h3><p>Our study shows that, when compared with nonobese controls, patients with LBMI are at an increased risk of endoscopy-related AEs. Appropriate precautions must be considered while performing routine endoscopic procedures to offset these risks in such patients.</p></div>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590030723000776\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590030723000776","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
Low Body Mass Index and Risk of Endoscopy-Related Adverse Events: A United States Cohort Propensity Score—Matched Study
Background and Aims
Patients with a low body mass index (LBMI) are often encountered in routine outpatient gastrointestinal (GI) endoscopy practice, and the assessment of procedure-related risks in this subset of individuals remains paramount. Although the risk of endoscopy-related adverse events (AEs) has been reported in patients with obesity, the association between LBMI and AEs has not been established.
Methods
We conducted a retrospective cohort study using TriNetX, a multi-institutional database, to assess the risk of endoscopy-related AEs in patients with LBMI (<18.4 kg/m2) compared with patients with a nonobese body mass index (18.5-29.9 kg/m2) (control cohort) after low-risk outpatient diagnostic esophagogastroduodenoscopy (EGD), colonoscopy, or percutaneous endoscopic gastrostomy (PEG) tube placement. One-to-one (1:1) propensity score matching was performed. The primary endpoints were to assess the risk of GI bleeding, perforation, or aspiration pneumonia within 30 days. Risk was expressed as adjusted odds ratios (aORs) with 95% confidence intervals.
Results
A total of 28,677, 18,449, and 3076 patients with LBMI underwent EGD, colonoscopy, and PEG tube placement, respectively. After propensity score matching, compared with the control cohort, patients with LBMI undergoing EGD and colonoscopy with or without biopsies were at an increased risk for GI bleeding (aOR 1.36 and 2.21), perforation (aOR 1.96 and 2.65), and aspiration pneumonia (aOR 3.13 and 2.71), respectively. Additionally, patients in the LBMI PEG cohort were found to be at an increased risk for aspiration pneumonia (aOR 1.33).
Conclusion
Our study shows that, when compared with nonobese controls, patients with LBMI are at an increased risk of endoscopy-related AEs. Appropriate precautions must be considered while performing routine endoscopic procedures to offset these risks in such patients.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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