Clinical predictors of symptom improvement failure in gastroparesis.
| Autor: | Amjad W; Internal Medicine, Albany Medical Center, Albany NY (Waseem Amjad, Asha Pandu, Muhammad Shabbir).; Clinical Research, Harvard Medical School, Boston MA (Waseem Amjad)., Doycheva I; Endocrinology and Metabolism, University of Chicago, Chicago IL (Iliana Doycheva)., Kamal F; Gastroenterology and Hepatology, University of Tennessee, Memphis, TN (Faisal Kamal)., Malik A; Internal Medicine, Loyola University Medical Center, Chicago, IL (Adnan Malik)., Pandu A; Internal Medicine, Albany Medical Center, Albany NY (Waseem Amjad, Asha Pandu, Muhammad Shabbir)., Shabbir MA; Internal Medicine, Albany Medical Center, Albany NY (Waseem Amjad, Asha Pandu, Muhammad Shabbir)., Mumtaz M; Endocrinology, Albany Medical Center, Albany, NY (Mirrah Mumtaz)., Batool A; Gastroenterology and Hepatology, Albany Medical Center, Albany, NY (Asra Batool)., Ukleja A; Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Andrew Ukleja), USA. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of gastroenterology [Ann Gastroenterol] 2022 Mar-Apr; Vol. 35 (2), pp. 119-126. Date of Electronic Publication: 2022 Feb 14. |
| DOI: | 10.20524/aog.2022.0696 |
| Abstrakt: | Background: The aim of this study was to determine clinical predictors of gastroparesis outcomes. Methods: Between September 30, 2009 and January 31, 2020, we identified patients with gastroparesis diagnosed based on a 99m Tc sulfur-labeled gastric emptying test. The patients who had no symptom improvement at 4 and 12 weeks were considered to have failed to show clinical improvement. Logistic regression was used to compute the association between different factors and clinical outcomes. Results: We identified 320 patients (mean age 47.5±5.3 years, 70.3% female, 71.3% Whites). Failure of clinical improvement was seen in 34.7% patients at 4 weeks and 27.5% at 12 weeks after the gastroparesis diagnosis. At 4 weeks, chronic kidney disease (adjusted odds ratio [aOR] 2.62, 95% confidence interval [CI] 1.31-5.26; P=0.007) and body mass index (BMI) <18.5 kg/m 2 (aOR 9.90, 95%CI 2.98-32.93; P<0.001) were associated with a lack of improvement, whereas type 2 diabetes mellitus (T2DM) was associated with better clinical outcomes (aOR 0.50, 95%CI 0.25-0.99; P=0.047). At 12 weeks, subjects who had undergone post-bariatric surgery had no improvement of their gastroparesis symptoms (aOR 2.43, 95%CI 1.01-5.82; P=0.047), whereas T2DM was associated with clinical improvement (aOR 0.46, 95%CI 0.22-0.95; P=0.035). The subgroup analysis showed that BMI <18.5 kg/m 2 in non-diabetics and peripheral neuropathy in diabetics were associated with persistent symptoms. Conclusions: Gastroparesis patients with T2DM had significant symptom improvement. A history of bariatric surgery and renal failure were associated with worse clinical improvement. Peripheral neuropathy in diabetics was associated with persistent symptoms. Competing Interests: Conflict of Interest: None (Copyright: © Hellenic Society of Gastroenterology.) |
| Databáze: | MEDLINE |
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