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Impact of metabolic dysfunction-associated steatotic liver disease on COVID-19 hospitalizations:A propensity-matched analysis of the United States

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World Journal of Virology 2024年第1期13卷 51-60页

作者： Abdullah Sohail Hassam Ali Pratik Patel Subanandhini Subramanium Dushyant Singh Dahiya Amir H Sohail manesh kumar gangwani Sanjaya k Satapathy Department of Internal Medicine University of Iowa Roy J and Lucille A Carver College of MedicineIowaIA 52242United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Gastroenterology Mather Hospital/Hofstra University Zucker School of MedicineNY11777United States Department of Internal Medicine East Carolina University Brody School of MedicineGreenvilleNC 27834United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery University of New MexicoAlbuquerqueNM 87106United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Section on Gastroenterology and Hepatology North Shore University Hospital and Long Island Jewish Medical CenterManhassetNY 11030United States

BACkGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD),formally known as nonalcoholic fatty liver disease,is the most common chronic liver disease in the United *** with MASLD have been reported to be at a higher risk of developing severe coronavirus disease 2019(COVID-19)and ***,most studies are single-center studies,and nationwide data in the AIM To study the influence of MASLD on COVID-19 hospitalizations during the initial phase of the *** We retrospectively analyzed the 2020 National Inpatient Sample(NIS)database to identify primary COVID-19 hospitalizations based on an underlying diagnosis of MASLD.A matched comparison cohort of COVID-19 hospit-alizations without MASLD was identified from NIS after 1:N propensity score matching based on gender,race,and comorbidities,including hypertension,heart failure,diabetes,and *** primary outcomes included inpatient mortality,length of stay,and hospitalization *** outcomes included the prevalence of systemic *** A total of 2210 hospitalizations with MASLD were matched to 2210 hospitalizations without MASLD,with a good comorbidity ***,there was a higher prevalence of severe disease with more intensive care unit admissions(9.5%vs 7.2%,P=0.007),mechanical ventilation(7.2%vs 5.7%,P=0.03),and septic shock(5.2%vs 2.7%,P<0.001)in the MASLD cohort than in the non-MASLD ***,there was no difference in mortality(8.6%vs 10%,P=0.49),length of stay(5 d vs 5 d,P=0.25),and hospitalization costs(42081.5$vs 38614$,P=0.15)between the MASLD and non-MASLD *** The presence of MAFLD with or without liver cirrhosis was not associated with increased mortality in COVID-19 hospitalizations;however,there was an increased incidence of severe COVID-19 *** data(2020)predates the availability of COVID-19 vaccines,and many MASLD patients have since been *** will be interesting to see if these trends are

关键词： COVID-19 Metabolic dysfunction-associated steatotic liver disease Prevalence Hospital charges Inpatient resource utilization

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Global trends in hepatitis C-related hepatocellular carcinoma mortality:A public database analysis(1999-2019)

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World Journal of Virology 2024年第1期13卷 69-83页

作者： Hassam Ali Fnu Vikash Vishali Moond Fatima khalid Abdur Rehman Jamil Dushyant Singh Dahiya Amir Humza Sohail manesh kumar gangwani Pratik Patel Sanjaya k Satapathy Department of Internal Medicine/Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of Internal Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Department of Internal Medicine Saint Peter's University Hospital/Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of Internal Medicine Quaid-e-Azam Medical CollegeBahawalpur 63100PunjabPakistan Department of Internal Medicine Samaritan Medical CentreWatertownMA 13601United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery New York University Winthrop HospitalNew YorkMineloaNY 11501United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology Mather Hospital/Hofstra University Zucker School of MedicineNY 11777United States Division of Hepatology Department of MedicineNorth Shore University HospitalManhassetNY 11030United States

BACkGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical *** the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis ***,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global *** some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender *** gap in knowledge hinders the development of targeted interventions and resource allocation *** The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two ***,females exhibited a remarkable decrease in mortality compared to ***,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward *** America and the Caribbean also experienced an increase in mortality ***,no significant difference was observed in the Middle East and North *** America exhibited a notable upward *** Asia and Sub-Saharan Africa significantly declined throughout the study *** raises the hope of identifying areas for implementing more targeted *** some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].

关键词： Carcinoma Hepatocellular Antiviral agents Global Burden of Disease Quality indicators Health care Liver neoplasms Hepatitis C Chronic hepatitis C

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Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions

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World Journal of Hepatology 2024年第1期16卷 17-32页

作者： Yash R Shah Hassam Ali Angad Tiwari David Guevara-Lazo Natalia Nombera-Aznaran Bhanu Siva Mohan Pinnam manesh kumar gangwani Harishankar Gopakumar Amir H Sohail SriLakshmiDevi kanumilli Ernesto Calderon-Martinez Geetha krishnamoorthy Nimish Thakral Dushyant Singh Dahiya Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Maharani Laxmi Bai Medical CollegeJhansi 284001India Faculty of Medicine Universidad Peruana Cayetano HerediaLima 15102Peru Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology and Hepatology University of Illinois College of Medicine at PeoriaPeoriaIL 61605United States Department of Surgery University of New MexicoAlbuquerqueNM 87106United States Department of Internal Medicine GSL Medical CollegeRajamahendravaram 533296India Department of Internal Medicine Universidad Nacional Autonoma de MexicoCiudad De Mexico 04510Mexico Department of Digestive Diseases and Nutrition University of KentuckyLexingtonKY 40536United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States

Fecal microbiota transplantation(FMT)offers a potential treatment avenue for hepatic encephalopathy(HE)by leveraging beneficial bacterial displacement to restore a balanced gut *** prevalence of HE varies with liver disease severity and *** pathogenesis involves ammonia toxicity,gut-brain communication disruption,and *** aims to restore gut microbiota balance,addressing these ***'s efficacy has been explored in various conditions,including *** suggest that FMT can modulate gut microbiota,reduce ammonia levels,and alleviate *** has shown promise in alcohol-associated,hepatitis B and C-associated,and non-alcoholic fatty liver *** include improved liver function,cognitive function,and the slowing of disease ***,larger,controlled studies are needed to validate its effectiveness in these *** have shown cognitive improvements through FMT,with potential benefits in cirrhotic ***,trials have demonstrated reduced serious adverse events and cognitive enhancements in FMT arms compared to the standard of *** evidence is promising,challenges remain:Limited patient numbers,varied dosages,administration routes,and donor *** large-scale,controlled trials are essential to establish standardized guidelines and ensure FMT's clinical applications and *** FMT holds potential for HE management,ongoing research is needed to address these challenges,optimize protocols,and expand its availability as a therapeutic option for diverse hepatic conditions.

关键词： Hepatic encephalopathy Fecal microbiota transplant Cognitive impairment Liver cirrhosis Chronic liver disease

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Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding:A nationwide analysis

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World Journal of Gastrointestinal Endoscopy 2023年第4期15卷 285-296页

作者： Simcha Weissman Muhammad Aziz Ayrton I Bangolo Dean Ehrlich Arnold Forlemu Anthony Willie manesh k gangwani Danish Waqar Hannah Terefe Amritpal Singh Diego MC Gonzalez Jayadev Sajja Fatma L Emiroglu Nicholas Dinko Ahmed Mohamed Mark A Fallorina David kosoy Ankita Shenoy Anvit Nanavati Joseph D Feuerstein James H Tabibian Department of Internal Medicine Palisades Medical CenterNorth BergenNJ 07047United States Department of Gastroenterology University of Toledo Medical CenterToledoOH 43614United States Division of Digestive Diseases David Geffen School of Medicine at University of California at Los AngelesLos AngelesCA 90095United States Department of Internal Medicine Creighton University School of MedicinePhoenixAZ 85012United States Division of Gastroenterology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States Division of Gastroenterology Department of MedicineOlive View-University of California at Los Angeles Medical CenterSylmarCA 91342United States

BACkGROUND The optimal timing of esophagogastroduodenoscopy(EGD)and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding(NVUGIB)remains an area of active *** To identify independent predictors of outcomes in patients with NVUGIB,with a particular focus on EGD timing,anticoagulation(AC)status,and demographic *** A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICD-9 codes from the National Inpatient Sample *** were stratified by EGD timing relative to hospital admission(≤24 h,24-48 h,48-72 h,and>72 h)and then by AC status(yes/no).The primary outcome was all-cause inpatient *** outcomes included healthcare *** Of the 1082516 patients admitted for NVUGIB,553186(51.1%)underwent *** mean time to EGD was 52.8 ***(kelihood of discharge to home(all with P<0.001).AC status was not associated with mortality among patients who underwent early EGD(aOR 0.88,P=0.193).Male sex(OR 1.30)and Hispanic(OR 1.10)or Asian(aOR 1.38)race were also independent predictors of adverse hospitalization outcomes in *** Based on this large,nationwide study,early EGD in NVUGIB is associated with lower mortality and decreased healthcare usage,irrespective of AC *** findings may help guide clinical management and would benefit from prospective validation.

关键词： Upper gastrointestinal bleeding Esophagogastroduodenoscopy Outcomes Mortality Anticoagulation

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Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 148-156页

作者： Sanket Dhirubhai Basida Dushyant Singh Dahiya Muhammad Nadeem Yousaf Brinda Basida Bhanu Siva Mohan Pinnam manesh kumar gangwani Hassam Ali Sahib Singh Yash R Shah Daksh Ahluwalia Mihir Prakash Shah Saurabh Chandan Neil R Sharma Shyam Thakkar Department of Internal Medicine University of Missouri-ColumbiaColumbiaMO 65212United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Division of Gastroenterology and Hepatology University of MissouriColumbiaMO 65212United States Department of Rheumatology Medical College of GeorgiaAugusta UniversityNorth AugustaGA 30912United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology East Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Interventional Oncology&Surgical Endoscopy GI Oncology Tumor Site TeamParkview Cancer InstituteParkview HealthFort WayneIN 46845United States Section of Gastroenterology&Hepatology West Virginia University School of MedicineMorgantownWV 26505United States

BACkGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic *** and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related *** To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning *** This is a cohort study using the 2018-2020 National Readmission *** aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical *** Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and *** primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to *** used univariate and multivariate regression models for *** A total of 9448 patients were admitted for any indications of *** and non-frail patients were 3445(36.46%)and 6003(63.53%)*** for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(Pk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared

关键词： Endoscopic retrograde cholangiopancreatography Nonagenarians Frailty Mortality Healthcare burden

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Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

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World Journal of Gastrointestinal Endoscopy 2024年第7期16卷 385-395页

作者： Dushyant Singh Dahiya Ganesh kumar Syeda Parsa manesh kumar gangwani Hassam Ali Amir Humza Sohail Saqr Alsakarneh Umar Hayat Sheza Malik Yash R Shah Bhanu Siva Mohan Pinnam Sahib Singh Islam Mohamed Adishwar Rao Saurabh Chandan Mohammad Al-Haddad Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityMO 66160United States Department of Internal Medicine Chandka Medical CollegeSindh 77280Pakistan Department of Gastroenterology and Hepatology University of Arkansas For Medical SciencesLittle RockAR 72205United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64108United States Department of Internal Medicine Geisinger Wyoming Valley Medical CenterWilkes BarrePA 18711United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Sinai hospitalBaltimoreMD 21215United States Department of Hepatology University of MissouriColumbiaMO 65211United States Department of Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient ***,benzodiazepines and opioids continue to be widely ***,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)*** is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural *** has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug *** also has satisfactory efficacy and has achieved high rates of successful sedation in GI ***,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the ***,the use of Propofol is associated with hemodynamic instability and respiratory *** contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural *** this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural *** also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

关键词： Remimazolam Endoscopy Sedation Outcomes Efficacy Safety Pharmacokinetics

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Sepsis during short bowel syndrome hospitalizations:Identifying trends,disparities,and clinical outcomes in the United States

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 26-36页

作者： Dushyant Singh Dahiya Jennifer Wachala Shantanu Solanki Dhanshree Solanki Asim kichloo Samantha Holcomb Uvesh Mansuri khwaja Saad Haq Hassam Ali manesh kumar gangwani Yash R Shah Teresa Varghese Hafiz Muzaffar Akbar khan Simon Peter Horslen Thomas D Schiano Syed-Mohammed Jafri Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Division of Gastroenterology Hepatology&Nutrition The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Medicine Institute for Foreign Medical Graduate EducationHoustonTX 77030United States Department of Internal Medicine MedStar Harbor HospitalBaltimoreMD 21225United States Department of Internal Medicine WellStar Spalding Regional HospitalGriffinGA 30224United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology SUNY Upstate Medical UniversitySyracuseNY 13210United States Department of Pediatrics School of Medicine and UPMC Children’s Hospital of PittsburghUniversity of PittsburghPittsburghPA 15219United States Division of Liver Diseases Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Division of Gastroenterology and Hepatology Henry Ford HospitalDetroitMI 48202United States

BACkGROUND Short bowel syndrome(SBS)hospitalizations are often complicated with *** is a significant paucity of data on adult SBS hospitalizations in the United States and across the *** To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United *** The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between *** study cohort was further divided based on the presence or absence of *** were identified,and hospitalization characteristics and clinical outcomes were *** of mortality for SBS hospitalizations complicated with sepsis were *** Of 247097 SBS hospitalizations,21.7%were complicated by *** SBS hospitalizations had a rising trend of hospitalizations from 20.8%in 2005 to 23.5%in 2014(P trendks(12.4%vs 11.3%,P<0.0001)and Hispanics(6.7%vs 5.5%,P<0.0001).Furthermore,septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation(0.33%vs 0.22%,P<0.0001),inpatient mortality(8.5%vs 1.4%,P<0.0001),and mean length of stay(16.1 d vs 7.7 d,P<0.0001)compared to the non-sepsis cohort.A younger age,female gender,White race,and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS *** Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

关键词： Short bowel syndrome Sepsis Outcomes Mortality Trends

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Clinical characteristics and outcomes of autoimmune pancreatitis based on serum immunoglobulin G4 levels:A single-center,retrospective cohort study

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World Journal of Gastroenterology 2023年第47期29卷 6161-6164页

作者： Fouad Jaber khaled Elfert Saqr Alsakarneh Azizullah Beran Mohammed Jaber manesh kumar gangwani Yazan Abboud Department of Internal Medicine University of Missouri-Kansas CityKansasMO 64108United States Department of Internal Medicine SBH Health SystemNew YorkNY 10457United States Department of Gastroenterology Indiana University420 University BlvdIndianapolisIN 46202United States Department of Medical Education Al Azhar University School of MedicineGaza P.O.Box 108Palestine Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarNJ 57873United States

Autoimmune pancreatitis(AIP)is a complex,poorly understood disease gaining increasing attention."Clinical Characteristics and Outcome of AIP Based on Serum IgG4 levels,"investigated AIP with a focus on serum immunoglobulin(Ig)G4 *** 213 patients with AIP were classified according to serum IgG4 levels:Abnormal(elevated)and *** with higher IgG4 levels exhibited a more active immune system and increased relapse *** IgG4,the IgA levels and age independently contributed to relapse risk,guiding risk assessment and tailored treatments for better ***,limitations persist,such as no IgA correlation with IgG4 levels,absent data on autoantibodypositive AIP cases critical for Asian diagnostic criteria,and unexplored relapse rates in high serum IgG AIP by *** factors and family histories were not *** the understanding and referral of seronegative AIPs increase,there's a growing need for commercially available,highly sensitive,and specific autoantibodies to aid in diagnosing individuals with low or absent serum IgG4 levels.

关键词： Autoimmune pancreatitis Relapse Immunoglobulin G Immune System,Immunoglobulin A Outcomes

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Peptic ulcer disease in non-alcoholic fatty liver disease hospitalizations:A new challenge on the horizon in the United States

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World Journal of Hepatology 2023年第4期15卷 564-576页

作者： Dushyant Singh Dahiya Vinay Jahagirdar Hassam Ali manesh kumar gangwani Muhammad Aziz Saurabh Chandan Amandeep Singh Abhilash Perisetti Aakriti Soni Sumant Inamdar Madhusudhan R Sanaka Mohammad Al-Haddad Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States Department of Internal Medicine East Carolina UniversityGreenvilleNC 27858United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68131United States Department of Gastroenterology Hepatology and NutritionCleveland Clinic FoundationClevelandOH 44195United States Division of Gastroenterology and Hepatology Kansas City Veterans Affairs Medical CenterKansas CityMO 64128United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACkGROUND Peptic ulcer disease(PUD)is frequently seen in patients with liver ***,current literature lacks data on PUD in non-alcoholic fatty liver disease(NAFLD)*** To identify trends and clinical outcomes of PUD in NAFLD hospitalizations in the United *** The National Inpatient Sample was utilized to identify all adult(≥18 years old)NAFLD hospitalizations with PUD in the United States from *** trends and outcomes were ***,a control group of adult PUD hospitalizations without NAFLD was also identified for a comparative analysis to assess the influence of NAFLD on *** The total number of NAFLD hospitalizations with PUD increased from 3745 in 2009 to 3805 in *** noted an increase in the mean age for the study population from 56 years in 2009 to 63 years in 2019(Pks and *** all-cause inpatient mortality for NAFLD hospitalizations with PUD increased from 2%in 2009 to 5%in 2019(P<0.001).However,rates of Helicobacter pylori(***)infection and upper endoscopy decreased from 5%in 2009 to 1%in 2019(P<0.001)and from 60%in 2009 to 19%in 2019(P<0.001),***,despite a significantly higher comorbidity burden,we observed lower inpatient mortality(2%vs 3%,P=0.0004),mean length of stay(LOS)(11.6 vs 12.1 d,P<0.001),and mean total healthcare cost(THC)($178598 vs$184727,P<0.001)for NAFLD hospitalizations with PUD compared to non-NAFLD PUD *** of the gastrointestinal tract,coagulopathy,alcohol abuse,malnutrition,and fluid and electrolyte disorders were identified to be independent predictors of inpatient mortality for NAFLD hospitalizations with *** Inpatient mortality for NAFLD hospitalizations with PUD increased for the study ***,there was a significant decline

关键词： Non-alcoholic fatty liver disease Peptic ulcer disease Trends Outcomes Mortality

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Acute pancreatitis in liver transplant hospitalizations:Identifying national trends,clinical outcomes and healthcare burden in the United States

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World Journal of Hepatology 2023年第6期15卷 797-812页

作者： Dushyant Singh Dahiya Vinay Jahagirdar Saurabh Chandan manesh kumar gangwani Nooraldin Merza Hassam Ali Smit Deliwala Muhammad Aziz Daryl Ramai Bhanu Siva Mohan Pinnam Jay Bapaye Chin-I Cheng Sumant Inamdar Neil R Sharma Mohammad Al-Haddad Department of Internal Medicine Central Michigan University College of MedicineSaginawMI 48601United States Department of Internal Medicine University of Missouri-Kansas CityKansas CityMO 64110United States Division of Gastroenterology and Hepatology CHI Creighton University Medical CenterOmahaNE 68131United States Department of Internal Medicine The University of ToledoToledoOH 43606United States Department of Internal Medicine East Carolina UniversityGreenvilleNC 27858United States Division of Digestive Diseases Emory University School of MedicineAtlantaGA 30322United States Division of Gastroenterology and Hepatology The University of ToledoToledoOH 43606United States Division of Gastroenterology and Hepatology The University of Utah School of MedicineSalt Lake CityUT 84112United States Department of Internal Medicine John H.Stroger Hospital of Cook CountyChicagoIL 60612United States Department of Internal Medicine Rochester General HospitalRochesterNY 14621United States Department of Statistics Actuarial and Data ScienceCentral Michigan UniversityMt.PleasantMI 48859United States Division of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Interventional Oncology and Surgical Endoscopy Programs Parkview Cancer InstituteFort WayneIN 46845United States Division of Gastroenterology and Hepatology Indiana University School of MedicineIndianapolisIN 46202United States

BACkGROUND Acute pancreatitis(AP)in liver transplant(LT)recipients may lead to poor clinical outcomes and development of severe *** We aimed to assess national trends,clinical outcomes,and the healthcare burden of LT hospitalizations with AP in the United States(US).METHODS The National Inpatient Sample was utilized to identify all adult(≥18 years old)LT hospitalizations with AP in the US from 2007–***-LT AP hospitalizations served as controls for comparative *** trends of hospitalization characteristics,clinical outcomes,complications,and healthcare burden for LT hospitalizations with AP were *** characteristics,clinical outcomes,complications,and healthcare burden were also compared between the LT and non-LT ***,predictors of inpatient mortality for LT hospitalizations with AP were *** P values≤0.05 were considered statistically *** The total number of LT hospitalizations with AP increased from 305 in 2007 to 610 in *** was a rising trend of Hispanic(16.5%in 2007 to 21.1%in 2018,P-trend=0.0009)and Asian(4.3%in 2007 to 7.4%in 2019,p-trend=0.0002)LT hospitalizations with AP,while a decline was noted for Blacks(11%in 2007 to 8.3%in 2019,P-trend=0.0004).Furthermore,LT hospitalizations with AP had an increasing comorbidity burden as the Charlson Comorbidity Index(CCI)score≥3 increased from 41.64%in 2007 to 62.30%in 2019(P-trendkidney failure(AkF),acute respiratory failure(ARF),abdominal abscesses,portal vein thrombosis(PVT),and venous thromboembolism(VTE).Between 2007–2019,6863 LT hospitalizations with AP were compared to 5649980 non-LT AP *** hospitalizations with AP were slightly older(53.5 vs 52.6 years,P=0.017)and

关键词： Liver transplantation Pancreatitis Mortality Cost Length of stay

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