Endoscopy Is Not Associated with Infectious Adverse Events After Hematopoietic Cell Transplantation: A Retrospective Cohort Study
| Autor: | James N. Gerson, Ravy K. Vajravelu, Rahul S. Dalal, Abraham Segura, James D. Lewis, Meghana Golla, Nadim Mahmud |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Physiology medicine.medical_treatment Colonoscopy Hematopoietic stem cell transplantation Endoscopy Gastrointestinal Article 03 medical and health sciences 0302 clinical medicine Sepsis Internal medicine Humans Medicine Adverse effect Retrospective Studies medicine.diagnostic_test business.industry Hematopoietic Stem Cell Transplantation Gastroenterology Retrospective cohort study Odds ratio Hepatology Endoscopy Transplantation surgical procedures operative 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business |
| Zdroj: | Dig Dis Sci |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | BACKGROUND: Patients with recent hematopoietic cell transplantation (HCT) are considered high risk for gastrointestinal endoscopy due to the potential for procedural bacterial translocation. Prior studies investigating these risks do not account for the higher baseline rate of infectious complications among those who are immunocompromised. We performed a retrospective cohort study of patients with recent HCT who underwent endoscopy and their matched controls who did not undergo endoscopy. METHODS: We identified patients who underwent HCT followed by upper and/or lower endoscopy at the University of Pennsylvania from 2000 to 2018. Individuals were matched 1:1 by age, sex, and type of HCT to controls who underwent HCT without subsequent endoscopy. Infectious adverse events were assessed by Sepsis-3 and Sepsis-2 criteria. Factors associated with infectious adverse events after endoscopy/index date were assessed using multivariable conditional logistic regression. RESULTS: We identified 149 patients who underwent HCT and endoscopy and 149 matched controls who underwent HCT without endoscopy. Sepsis-3 infectious adverse events occurred in 3.4% of patients in each group. Sepsis-2 infectious adverse events occurred in 20.1% of patients who underwent endoscopy compared to 19.5% of controls. There was no association between endoscopy and Sepsis-2 infectious adverse events in the multivariable regression analysis (adjusted odds ratio 1.65, 95% CI 0.51–5.26). CONCLUSIONS: When compared to controls with similar immune statuses, patients who underwent endoscopy after HCT did not have a higher risk of infectious adverse events. These results may inform clinical decision making regarding the risks and benefits of endoscopic management after HCT. |
| Databáze: | OpenAIRE |
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