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首页> 外文期刊>Digestive Diseases and Sciences >Early Endoscopy Is Associated with Better Clinical Outcomes in Patients Hospitalized with Ischemic Bowel Disease
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Early Endoscopy Is Associated with Better Clinical Outcomes in Patients Hospitalized with Ischemic Bowel Disease

机译：早期内窥镜检查与患有缺血性肠病病患者的患者更好的临床结果有关

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Background and Aims Providing diagnostic and therapeutic interventions, lower gastrointestinal endoscopy is a salient investigative modality for ischemic bowel disease (IB). As studies on the role of endoscopic timing on the outcomes of IB are lacking, we sought to clarify this association. Methods After identifying 18-to-90-year-old patients with a primary diagnosis of IB from the 2012-2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, we grouped them based on timing of endoscopy into three: early (n = 9268), late (n = 3515), and no endoscopy (n = 18,452). We explored the determinants of receiving early endoscopy, the impact of endoscopic timing on outcomes (mortality and 13 others), and the impact of the type of endoscopy (colonoscopy vs. sigmoidoscopy) on these outcomes among the early group (SAS 9.4). Results Less likely to receive early endoscopy were Blacks compared to Whites (adjusted odds ratio [aOR] 0.81 95% CI [0.70-0.94]), and individuals on Medicaid, Medicare, and uninsured compared to the privately insured group (aOR 0.80 [0.71-0.91], 0.70 [0.58-0.84], and 0.68 [0.56-0.83]). Compared to the late and no endoscopy groups, patients with early endoscopy had less mortality (aOR 0.53 [0.35-0.80] and 0.09 [0.07-0.12]), shorter length of stay (LOS, 4.64 [4.43-4.87] days vs. 8.87 [8.40-9.37] and 6.62 [6.52-7.13] days), lower total hospital cost (THC, $41,055 [$37,995-$44,361] vs. $72,598 [$66,768-$78,937] and $68,737 [$64,028-$73,793]), and better outcomes. Similarly, among those who received early endoscopy, colonoscopy had better outcomes than sigmoidoscopy for mortality, THC, LOS, and adverse events. Conclusion Early endoscopy, especially colonoscopy, is associated with better clinical outcomes and decreased healthcare utilization in IB. Unfortunately, there are disparities against Blacks, and non-privately insured individuals in receiving early endoscopy.
机译：背景和旨在提供诊断和治疗干预的胃肠内窥镜检查是缺血性肠病（IB）的突出的调查模态。由于对内窥镜时机对IB成果的作用的研究缺乏，我们试图澄清这一协会。方法在鉴定2012 - 2014年医疗保健成本和利用项目全国性的IB初步诊断18至90岁患者后，我们将基于内窥镜检查的时序分为三个：早期（n = 9268 ），晚期（n = 3515），没有内窥镜检查（n = 18,452）。我们探索了接受早期内窥镜检查的决定因素，内窥镜时机对结果（死亡率和13个其他）的影响，以及内窥镜检查类型（结肠镜检查与Sigmoidoctopy）对早期组的这些结果的影响（SAS 9.4）。与白人相比-0.91]，0.70 [0.58-0.84]和0.68 [0.56-0.83]）。与晚期和无内窥镜群体相比，早期内窥镜检查的患者的死亡率较少（AOR 0.53 [0.35-0.80]和0.09 [0.07-0.12]），较短的住院时间（LOS，4.64 [4.43-4.87]日与8.87 [8.40-9.37]和6.62 [6.52-7.13]天数，较低的医院费用降低（THC，41,055美元 - $ 44,995- $ 44,361]和66,768美元 - $ 78,937]和68,737美元[64,028美元 - $ 73,793]）和更好的结果。同样，在接受早期内窥镜检查的人中，结肠镜检查比乙型过度镜检查具有更好的成果，用于死亡率，THC，LOS和不良事件。结论早期内窥镜检查，尤其是结肠镜检查，与更好的临床结果相关，并降低IB中的医疗利用率。不幸的是，在接受早期内窥镜检查时，存在对黑人的差异和非私人被保险人。

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