Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Suzuki Yutaka, Tamez Seryna, Murakami Akihiko, Taira Akihiko, Mizuhara Akihiro, Horiuchi Akira, Mihara Chie, Ako Eiji, Muramatsu Hirohito, Okano Hitoshi, Suenaga Hitoshi, Jomoto Kazuaki, Kobayashi Junya, Takifuji Katsunari, Akiyama Kazuhiro, Tahara Koh, Onishi Koji, Shimazaki Makoto, Matsumoto Masami, Ijima Masashi, Murakami Masato, Nakahori Masato, Kudo Michiaki, Maruyama Michio, Takahashi Mikako, Washizawa Naohiro, Onozawa Shigeru, Goshi Satoshi, Yamashita Satoyoshi, Ono Shigeki, Imazato Shin, Nishiwaki Shinji, Kitahara Shuichirou, Endo Takao, Iiri Takao, Nagahama Takeshi, Hikichi Takuto, Mikami Tatsuya, Yamamoto Tetsuo, Ogawa Tetsushi, Ogawa Tomoko, Ohta Tomoyuki, Matsumoto Toshifumi, Kura Toshiroh, Kikuchi Tsutomu, Iwase Tsuyoshi, Tsuji Tsuyotoshi, Nishiguchi Yukio, Urashima Mitsuyoshi
Аннотация
METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient's characteristics at PEG using log-rank tests and Cox proportional hazard models.
RESULTS: Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors.
CONCLUSION: These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors.