Digestive diseases and sciences · 2015
Risk Factors for Aspiration Pneumonia After Endoscopic Hemostasis.
СтатьяНазвание и аннотация: Перевод в очереди
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Kawanishi Koki, Kato Jun, Toda Nobuo, Yamagami Mari, Yamada Tomoharu, Kojima Kentaro, Ohki Takamasa, Seki Michiharu, Tagawa Kazumi
Аннотация
BACKGROUND: Although all types of endoscopic procedures harbor risk of aspiration, little is understood about risk factors for aspiration pneumonia developing after endoscopic hemostasis.
AIMS: The present study aimed to identify risk factors for aspiration pneumonia after endoscopic hemostasis.
METHODS: Charts from consecutive patients with upper gastrointestinal bleeding that had been treated by endoscopic hemostasis at a single center between January 2004 and January 2015 were retrospectively reviewed. Patient information and clinical characteristics including cause of hemorrhage, established prognostic scales, laboratory data, comorbidities, medications, duration of endoscopic hemostasis, vital signs, sedative use, and the main operator during the procedure were compared between patients who developed aspiration pneumonia and those who did not.
RESULTS: Aspiration pneumonia developed in 24 (4.8%) of 504 patients after endoscopic hemostasis. Endotracheal intubation was required for three of them, and one died of the complication. Multivariate analysis revealed that age >75 years (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.5-13.6; p = 0.0073), procedural duration >30 min (OR 5.6; 95% CI 1.9-18.2; p = 0.0023), hemodialysis (OR 3.6; 95% CI 1.2-11; p = 0.024), and a history of stroke (OR 3.8; 95% CI 1-14; p = 0.041) were independent risk factors for developing aspiration pneumonia.
CONCLUSIONS: Specific risk factors for aspiration pneumonia after endoscopic hemostasis were identified. Endoscopists should carefully consider aspiration pneumonia when managing older patients who are on hemodialysis, have a history of stroke, and undergo a longer procedure.
AIMS: The present study aimed to identify risk factors for aspiration pneumonia after endoscopic hemostasis.
METHODS: Charts from consecutive patients with upper gastrointestinal bleeding that had been treated by endoscopic hemostasis at a single center between January 2004 and January 2015 were retrospectively reviewed. Patient information and clinical characteristics including cause of hemorrhage, established prognostic scales, laboratory data, comorbidities, medications, duration of endoscopic hemostasis, vital signs, sedative use, and the main operator during the procedure were compared between patients who developed aspiration pneumonia and those who did not.
RESULTS: Aspiration pneumonia developed in 24 (4.8%) of 504 patients after endoscopic hemostasis. Endotracheal intubation was required for three of them, and one died of the complication. Multivariate analysis revealed that age >75 years (odds ratio (OR) 4.4; 95% confidence interval (CI) 1.5-13.6; p = 0.0073), procedural duration >30 min (OR 5.6; 95% CI 1.9-18.2; p = 0.0023), hemodialysis (OR 3.6; 95% CI 1.2-11; p = 0.024), and a history of stroke (OR 3.8; 95% CI 1-14; p = 0.041) were independent risk factors for developing aspiration pneumonia.
CONCLUSIONS: Specific risk factors for aspiration pneumonia after endoscopic hemostasis were identified. Endoscopists should carefully consider aspiration pneumonia when managing older patients who are on hemodialysis, have a history of stroke, and undergo a longer procedure.
Предметные рубрики MeSH
Age FactorsAgedArgon Plasma CoagulationCohort StudiesComorbidityCyanoacrylatesEndoscopy, GastrointestinalEsophageal and Gastric VaricesFemaleGastrointestinal HemorrhageHemostatic TechniquesHepatic EncephalopathyHumansKidney Failure, ChronicLigationLogistic ModelsMaleMallory-Weiss SyndromeMiddle AgedMultivariate AnalysisOdds RatioOperative TimePeptic Ulcer HemorrhagePneumonia, AspirationPostoperative ComplicationsRenal DialysisRetrospective StudiesRisk FactorsStrokeSurgical Instruments