ICU幸存者胃食管反流症状与健康相关生活质量

CHEST critical care Pub Date : 2025-05-19 DOI:10.1016/j.chstcc.2025.100169

Sachin Wali MD, DNB, DM , Mohan Gurjar MD , Samir Mohindra MD, DM , Prabhaker Mishra PhD , Shreyas H. Gutte MD, DM , Afzal Azim MD , Jitendra S. Chahar MD , Banani Poddar MD

{"title":"ICU幸存者胃食管反流症状与健康相关生活质量","authors":"Sachin Wali MD, DNB, DM , Mohan Gurjar MD , Samir Mohindra MD, DM , Prabhaker Mishra PhD , Shreyas H. Gutte MD, DM , Afzal Azim MD , Jitendra S. Chahar MD , Banani Poddar MD","doi":"10.1016/j.chstcc.2025.100169","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Gastroesophageal reflux disease (GERD) is a common clinical condition in the general population. However, no prospective study is available to estimate the burden of gastroesophageal reflux symptoms (GERSs) among survivors of the ICU.</div></div><div><h3>Research Question</h3><div>What are the incidence and severity of GERSs among survivors of the ICU?</div></div><div><h3>Study Design and Methods</h3><div>This prospective observational study was conducted in a 20-bed ICU at a university hospital in India. All adult survivors of the ICU were screened for the presence of GERSs, defined as presence of heartburn, regurgitation symptoms, or both ≥ 2 times/wk. Exclusions were: Glasgow Coma Scale score of < 15, presence of tracheostomy or feeding tube, open abdomen, and pregnancy. The severity of symptoms was assessed through the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score (range, 0-50, where 50 is worst) at 2 time points 6 weeks apart.</div></div><div><h3>Results</h3><div>During the study period, 116 patients were included, with a median age of 44 years (interquartile range [IQR], 26-59 years). Sixty-five patients (56%) were male, and the median admission Sequential Organ Failure Assessment score was 7 (IQR, 4-10). During the ICU stay, 59 patients (50.8%) required mechanical ventilation, 42 patients (36.2%) required vasopressors, and 11 patients (9.4%) received dialysis. Among them, 43 patients (37%) had history of GERSs before the illness. In the remaining 73 patients, 23 patients (31.5%) had new-onset GERSs. The use of medications known to increase the risk of GERD (eg, prednisolone, acetylsalicylic acid, and amlodipine) and the prolonged presence of a feeding tube were associated significantly with new-onset GERSs (OR, 4.49 [95% CI, 1.06-18.9; <em>P</em> = .04] and OR, 1.04 [95% CI, 1.00-1.09; <em>P</em> = .03]), respectively, even after adjusting for age and presence of preexisting known risk factors (diabetes, hypertension, and smoking and alcohol intake). The median GERD-HRQL score among patients with new-onset GERSs at follow-up decreased from 10 (IQR, 2-20) to 4 (IQR, 0-15; <em>P</em> = .01).</div></div><div><h3>Interpretation</h3><div>In this study, one-third of survivors of the ICU experienced new-onset GERSs. However, symptoms improved significantly at the 6-week follow-up.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: <span><span>NCT05193266</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 3","pages":"Article 100169"},"PeriodicalIF":0.0000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gastroesophageal Reflux Symptoms and Health-Related Quality of Life Among ICU Survivors\",\"authors\":\"Sachin Wali MD, DNB, DM , Mohan Gurjar MD , Samir Mohindra MD, DM , Prabhaker Mishra PhD , Shreyas H. Gutte MD, DM , Afzal Azim MD , Jitendra S. Chahar MD , Banani Poddar MD\",\"doi\":\"10.1016/j.chstcc.2025.100169\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Gastroesophageal reflux disease (GERD) is a common clinical condition in the general population. However, no prospective study is available to estimate the burden of gastroesophageal reflux symptoms (GERSs) among survivors of the ICU.</div></div><div><h3>Research Question</h3><div>What are the incidence and severity of GERSs among survivors of the ICU?</div></div><div><h3>Study Design and Methods</h3><div>This prospective observational study was conducted in a 20-bed ICU at a university hospital in India. All adult survivors of the ICU were screened for the presence of GERSs, defined as presence of heartburn, regurgitation symptoms, or both ≥ 2 times/wk. Exclusions were: Glasgow Coma Scale score of < 15, presence of tracheostomy or feeding tube, open abdomen, and pregnancy. The severity of symptoms was assessed through the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score (range, 0-50, where 50 is worst) at 2 time points 6 weeks apart.</div></div><div><h3>Results</h3><div>During the study period, 116 patients were included, with a median age of 44 years (interquartile range [IQR], 26-59 years). Sixty-five patients (56%) were male, and the median admission Sequential Organ Failure Assessment score was 7 (IQR, 4-10). During the ICU stay, 59 patients (50.8%) required mechanical ventilation, 42 patients (36.2%) required vasopressors, and 11 patients (9.4%) received dialysis. Among them, 43 patients (37%) had history of GERSs before the illness. In the remaining 73 patients, 23 patients (31.5%) had new-onset GERSs. The use of medications known to increase the risk of GERD (eg, prednisolone, acetylsalicylic acid, and amlodipine) and the prolonged presence of a feeding tube were associated significantly with new-onset GERSs (OR, 4.49 [95% CI, 1.06-18.9; <em>P</em> = .04] and OR, 1.04 [95% CI, 1.00-1.09; <em>P</em> = .03]), respectively, even after adjusting for age and presence of preexisting known risk factors (diabetes, hypertension, and smoking and alcohol intake). The median GERD-HRQL score among patients with new-onset GERSs at follow-up decreased from 10 (IQR, 2-20) to 4 (IQR, 0-15; <em>P</em> = .01).</div></div><div><h3>Interpretation</h3><div>In this study, one-third of survivors of the ICU experienced new-onset GERSs. However, symptoms improved significantly at the 6-week follow-up.</div></div><div><h3>Clinical Trial Registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: <span><span>NCT05193266</span><svg><path></path></svg></span>; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>\",\"PeriodicalId\":93934,\"journal\":{\"name\":\"CHEST critical care\",\"volume\":\"3 3\",\"pages\":\"Article 100169\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"CHEST critical care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949788425000425\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"CHEST critical care","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949788425000425","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

胃食管反流病（GERD）是普通人群常见的临床疾病。然而，目前尚无前瞻性研究评估ICU幸存者胃食管反流症状（gers）的负担。研究问题：ICU幸存者中gers的发生率和严重程度是什么？研究设计和方法本前瞻性观察研究在印度一所大学医院的20个床位的ICU进行。对ICU的所有成年幸存者进行gers筛查，gers的定义是存在烧心、反流症状或两者均存在≥2次/周。排除：格拉斯哥昏迷量表评分为15分，存在气管切开术或喂食管，开放腹部和怀孕。在间隔6周的2个时间点，通过胃食管反流病与健康相关的生活质量（GERD-HRQL）评分（范围0-50，其中50为最差）评估症状的严重程度。结果研究期间纳入116例患者，中位年龄44岁（四分位间距[IQR]， 26-59岁）。65例患者（56%）为男性，入院序贯性器官衰竭评分中位数为7分（IQR, 4-10）。在ICU住院期间，59例（50.8%）患者需要机械通气，42例（36.2%）患者需要血管加压剂，11例（9.4%）患者需要透析。其中43例（37%）患者在发病前有gers病史。其余73例患者中，23例（31.5%）为新发gers。使用已知会增加GERD风险的药物（如泼尼松龙、乙酰水杨酸和氨氯地平）和长时间使用饲管与新发GERD显著相关（OR为4.49 [95% CI, 1.06-18.9; P = 0.04]和OR为1.04 [95% CI, 1.00-1.09; P = 0.03]），即使在调整了年龄和既往已知危险因素（糖尿病、高血压、吸烟和饮酒）的存在后也是如此。随访时新发gers患者的GERD-HRQL评分中位数从10分（IQR, 2-20）降至4分（IQR, 0-15; P = 0.01）。在本研究中，三分之一的ICU幸存者经历了新发gers。然而，在6周的随访中，症状明显改善。临床试验注册网站clinicaltrials .gov；否。: NCT05193266;URL: www.clinicaltrials.gov

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Gastroesophageal Reflux Symptoms and Health-Related Quality of Life Among ICU Survivors

Background

Gastroesophageal reflux disease (GERD) is a common clinical condition in the general population. However, no prospective study is available to estimate the burden of gastroesophageal reflux symptoms (GERSs) among survivors of the ICU.

Research Question

What are the incidence and severity of GERSs among survivors of the ICU?

Study Design and Methods

This prospective observational study was conducted in a 20-bed ICU at a university hospital in India. All adult survivors of the ICU were screened for the presence of GERSs, defined as presence of heartburn, regurgitation symptoms, or both ≥ 2 times/wk. Exclusions were: Glasgow Coma Scale score of < 15, presence of tracheostomy or feeding tube, open abdomen, and pregnancy. The severity of symptoms was assessed through the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score (range, 0-50, where 50 is worst) at 2 time points 6 weeks apart.

Results

During the study period, 116 patients were included, with a median age of 44 years (interquartile range [IQR], 26-59 years). Sixty-five patients (56%) were male, and the median admission Sequential Organ Failure Assessment score was 7 (IQR, 4-10). During the ICU stay, 59 patients (50.8%) required mechanical ventilation, 42 patients (36.2%) required vasopressors, and 11 patients (9.4%) received dialysis. Among them, 43 patients (37%) had history of GERSs before the illness. In the remaining 73 patients, 23 patients (31.5%) had new-onset GERSs. The use of medications known to increase the risk of GERD (eg, prednisolone, acetylsalicylic acid, and amlodipine) and the prolonged presence of a feeding tube were associated significantly with new-onset GERSs (OR, 4.49 [95% CI, 1.06-18.9; P = .04] and OR, 1.04 [95% CI, 1.00-1.09; P = .03]), respectively, even after adjusting for age and presence of preexisting known risk factors (diabetes, hypertension, and smoking and alcohol intake). The median GERD-HRQL score among patients with new-onset GERSs at follow-up decreased from 10 (IQR, 2-20) to 4 (IQR, 0-15; P = .01).

Interpretation

In this study, one-third of survivors of the ICU experienced new-onset GERSs. However, symptoms improved significantly at the 6-week follow-up.

Clinical Trial Registration

ClinicalTrials.gov; No.: NCT05193266; URL: www.clinicaltrials.gov

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

CHEST critical care Critical Care and Intensive Care Medicine, Pulmonary and Respiratory Medicine

自引率

0.00%

发文量