Early Diagnosis of Neutropenic Enterocolitis by Bedside Ultrasound in Hematological Malignancies: A Prospective Study
| Autor: | Edoardo Benedetti, Riccardo Morganti, Sara Galimberti, Vittorio Ricchiuto, Emilia Bramanti, Enrico Orciuolo, Matteo Pelosini, Piero Lippolis, Chiara Arena, Benedetto Bruno, Francesca Martini, Francesco Caracciolo, F Cerri, Mario Petrini, Emanuele Neri |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Abdominal pain medicine.medical_treatment Neutropenia Gastroenterology Article Internal medicine medicine Blood culture Prospective cohort study ultrasound sonography Chemotherapy medicine.diagnostic_test business.industry Neutropenic enterocolitis General Medicine neutropenic enterocolitis medicine.disease digestive system diseases Intestinal infections Ultrasound sonography Relative risk intestinal infections Medicine medicine.symptom Complication business |
| Zdroj: | Journal of Clinical Medicine Volume 10 Issue 18 Journal of Clinical Medicine, Vol 10, Iss 4277, p 4277 (2021) Journal of clinical medicine 10 (2021): 4277-1–4277-12. doi:10.3390/jcm10184277 info:cnr-pdr/source/autori:Benedetti E.; Bruno B.; Martini F.; Morganti R.; Bramanti E.; Caracciolo F.; Galimberti S.; Lippolis P.; Neri E.; Arena C.; Cerri F.; Ricchiuto V.; Pelosini M.; Orciuolo E.; Petrini M./titolo:Early diagnosis of neutropenic enterocolitis by bedside ultrasound in hematological malignancies: A prospective study/doi:10.3390%2Fjcm10184277/rivista:Journal of clinical medicine/anno:2021/pagina_da:4277-1/pagina_a:4277-12/intervallo_pagine:4277-1–4277-12/volume:10 |
| ISSN: | 2077-0383 |
| DOI: | 10.3390/jcm10184277 |
| Popis: | (1) Background: Neutropenic enterocolitis (NEC) is a life-threatening complication following chemotherapy with high mortality rates. Early diagnosis is crucial to improve outcomes. We designed a large prospective study employing bedside ultrasonography (US) as a novel approach to allow early diagnosis and prompt treatment to reduce mortality. (2) Methods: NEC was defined as US or computed tomography (CT)-proven bowel wall thickness ≥ 4 mm at the onset of at least one of the following symptoms: fever and/or abdominal pain and/or diarrhea during neutropenia. From 2007 to 2018, 1754 consecutive patients underwent baseline bedside US that was invariably repeated within 12 h from the onset of symptom(s) suggestive of NEC. (3) Results: Overall, 117 episodes of NEC were observed, and overall mortality was 9.4%. Bowel wall thickening was invariably absent in the negative control group. Abdominal pain associated with one or more symptoms correlated with the highest relative risk (17.33), sensitivity (89.7%), specificity (100%), and accuracy (96.2%) for diagnosis. The combination of abdominal pain and fever at onset significantly correlated with worse survival (p < 0.0001, OR 13.85). BWT (p = 0.046), type of therapy (p = 0.049) and blood culture positivity (p = 0.003) correlated with worse survival. (4) Conclusions: Bedside ultrasound is a non-invasive and radiation free imaging technique for early diagnosis of NEC and its prompt treatment significantly reduced mortality. |
| Databáze: | OpenAIRE |
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