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Prevalence and risk factors associated with metabolic dysfunctionassociated steatohepatitis in patients with Helicobacter pylori infection: A population-based study

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World Journal of hepatology 2024年第10期16卷 1169-1176页

作者： Rashid Abdel-Razeq Lynn Bitar Elio R Bitar Chidera Onwuzo Mohamad-Noor Abu-Hammour Barish Eren Islam Mohamed Adejoke Johnson Antoine Boustany Somtochukwu Onwuzo Imad Asaad department of internal medicine Cleveland Clinic FoundationClevelandOH 44111United States Faculty of medicine Saint Joseph University of BeirutBeirut 11042020Lebanon Faculty of medicine American University of BeirutBeirut 11072020Lebanon department of medicine&Surgery General Hospital Lagos IslandLagos Island 101223LagosNigeria department of internal medicine Jacobi Medical Center/North Central Bronx HospitalBronxNY 10461United States division of gastroenterology Department of Internal MedicineUniversity of Florida College of MedicineJacksonvilleFL 32209United States department of gastroenterology Allegheny General HospitalPittsburghPA 15212United States department of gastroenterology Firelands HealthSanduskyOH 44870United States

BACKGROUND Helicobacter pylori(***)is associated with the development of gastrointestinal disorders ranging from gastritis to gastric *** evidence of the association between metabolic dysfunction-associated steatohepatitis(MASH)and *** infection in the literature is ***,we aim to evaluate the risk of developing MASH in patients who have had a diagnosis of *** infection independently of any confounding *** To evaluate the risk of developing MASH in patients who have had a diagnosis of *** *** This study used a validated multicenter research database of over 360 hospitals across 26 healthcare systems across the United States from 1999 to *** regression analysis assessed the risk of developing MASH,adjusting for confounders including *** infection,obesity,type 2 diabetes,hypertension,dyslipidemia,and male gender.A two-sided P value<0.05 was considered as statistically significant,and all statistical analyses were performed using R version 4.0.2(R Foundation for Statistical Computing,Vienna,Austria,2008).RESULTS A total of 79476132 individuals were screened in the database and 69232620 were selected in the final analysis after accounting for inclusion and exclusion ***(14.30%),patients with hyperlipidemia(70.35%),hypertension(73.86%),diabetes mellitus type 2(56.46%),and obese patients(58.15%)were more common in patients with MASH compared to *** a multivariate regression analysis,the risk of MASH was increased in diabetics[odds ratio(OR):3.55;95%CI:3.48-3.62],obese(OR:5.93;95%CI:5.81-6.04),males(OR:1.49;95%CI:1.46-1.52),individuals with hyperlipidemia(OR:2.43;95%CI:2.38-2.49)and *** infection(OR:2.51;95%CI:2.31-2.73).CONCLUSION This is the largest population-based study in the United States illustrating an increased prevalence and odds of developing MASH in patients with *** infection after adjusting for risk factors.

关键词： Metabolic dysfunction-associated steatohepatitis Metabolic dysfunction-associated steatotic liver disease Helicobacter Pylori Cirrhosis Liver

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Early versus delayed necrosectomy in pancreatic necrosis:A population-based cohort study on readmission,healthcare utilization,and in-hospital mortality

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World Journal of Methodology 2024年第3期14卷 55-67页

作者： Hassam Ali Faisal Inayat Vinay Jahagirdar Fouad Jaber Arslan Afzal Pratik Patel Hamza Tahir Muhammad Sajeel Anwar Attiq Ur Rehman Muhammad Sarfraz Ahtshamullah Chaudhry Gul Nawaz Dushyant Singh Dahiya Amir H Sohail Muhammad Aziz division of gastroenterology and hepatology East Carolina University Brody School of MedicineGreenvilleNC 27834United States department of internal medicine Allama Iqbal Medical CollegeLahorePunjab 54550Pakistan department of internal medicine University of Missouri-Kansas CityKansas CityMO 64108United States division of gastroenterology Mather Hospital and Zucker School of Medicine at Hofstra UniversityPort JeffersonNY 11777United States department of internal medicine Jefferson Einstein HospitalPhiladelphiaPA 19141United States department of internal medicine UHS Wilson Medical CenterJohnson CityNY 13790United States division of gastroenterology and hepatology Geisinger Wyoming Valley Medical CenterWilkes-BarrePA 18711United States department of internal medicine St.Dominic's HospitalJacksonMS 39216United States division of gastroenterology Hepatologyand MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States department of Surgery University of New Mexico School of MedicineAlbuquerqueNM 87106United States division of gastroenterology and hepatology The University of ToledoToledoOH 43606United States

BACKGROUND Acute necrotizing pancreatitis is a severe and life-threatening *** poses a considerable challenge for clinicians due to its complex nature and the high risk of *** minimally invasive and open necrosectomy procedures have been *** advancements in treatment modalities,the optimal timing to perform necrosectomy lacks *** To evaluate the impact of necrosectomy timing on patients with pancreatic necrosis in the United *** A national retrospective cohort study was conducted using the 2016-2019 Nationwide Readmissions *** with non-elective admissions for pancreatic necrosis were *** participants were divided into two groups based on the necrosectomy timing:The early group received intervention within 48 hours,whereas the delayed group underwent the procedure after 48 *** various intervention techniques included endoscopic,percutaneous,or surgical *** major outcomes of interest were 30-day readmission rates,healthcare utilization,and inpatient *** A total of 1309 patients with pancreatic necrosis were *** propensity score matching,349 cases treated with early necrosectomy were matched to 375 controls who received delayed *** early cohort had a 30-day readmission rate of 8.6% compared to 4.8%in the delayed cohort(P=0.040).Early necrosectomy had lower rates of mechanical ventilation(2.9%vs 10.9%,P<0.001),septic shock(8%vs 19.5%,P<0.001),and in-hospital mortality(1.1%vs 4.3%,P=0.01).Patients in the early intervention group incurred lower healthcare costs,with median total charges of $52202 compared to$147418 in the delayed *** in the early cohort also had a relatively shorter median length of stay(6 vs 16 days,P<0.001).The timing of necrosectomy did not significantly influence the risk of 30-day readmission,with a hazard ratio of 0.56(95%confidence interval:0.31-1.02,P=0.06).CONCLUSION Our findings show that

关键词： Acute necrotizing pancreatitis Pancreatic necrosis Early necrosectomy Delayed necrosectomy Readmission,Healthcare costs Mortality

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Anal carcinoma-exploring the epidemiology,risk factors,pathophysiology,diagnosis,and treatment

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World Journal of Experimental medicine 2024年第3期14卷 20-38页

作者： Kevan J English department of medicine Division of Gastroenterology&HepatologySaint George’s University School of MedicineSaint George 33334Saint GeorgeGrenada

Anal carcinoma is a relatively rare tumor that accounts for approximately 2%of gastrointestinal malignancies and less than 7%of anorectal *** anal tumors originate between the anorectal junction and the anal *** factors for the disease include human papillomavirus infection,human immunodeficiency virus,tobacco use,immunosuppression,female sex,and older *** pathogenesis of anal carcinoma is believed to be linked to human papillomavirusrelated inflammation,leading to dysplasia and progression to *** cell carcinoma is the most common type of anal tumor,with an annual incidence of approximately 1 to 2 per 100000 *** regarding anal cancer has emerged over ***,chemoradiation therapy remains the mainstay approach for early localized *** with metastatic disease are treated with systemic therapy,and salvage surgery is reserved for disease recurrence following *** article aims to provide background information on the epidemiology,risk factors,pathology,diagnosis,and current trends in the management of anal *** directions are briefly discussed.

关键词： Anal cancer Squamous cell carcinoma Chemoradiation therapy Human papillomavirus Immunosuppression

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Diseases of bile duct in children

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World Journal of gastroenterology 2024年第9期30卷 1043-1072页

作者： Sutha Eiamkulbutr Chomchanat Tubjareon Anapat Sanpavat Teerasak Phewplung Nimmita Srisan Palittiya Sintusek department of Pediatrics King Chulalongkorn Memorial HospitalBangkok 10330Thailand department of Pediatrics Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkok 10330Thailand department of Pathology Chulalongkorn UniversityBangkok 10330Thailand department of Radiology Chulalongkorn UniversityBangkok 10330Thailand department of Surgery Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalBangkok 10330Thailand Center of Excellence in Thai Pediatric gastroenterology Hepatology and ImmunologyDivision of GastroenterologyDepartment of PediatricsKing Chulalongkorn Memorial HospitalChulalongkorn UniversityBangkok 10330Thailand

Several diseases originate from bile duct *** studies on these diseases,certain etiologies of some of them still cannot be *** most common disease of the bile duct in newborns is biliary atresia,whose prognosis varies according to the age of surgical *** diseases such as Alagille syndrome,inspissated bile duct syndrome,and choledochal cysts are also time-sensitive because they can cause severe liver damage due to *** majority of these diseases present with cholestatic jaundice in the newborn or infant period,which is quite difficult to differentiate regarding clinical acumen and initial *** cholangiography is potentially necessary to make an accurate diagnosis,and further treatment will be performed synchronously or planned as findings *** article provides a concise review of bile duct diseases,with interesting cases.

关键词： Bile duct Cholestasis Biliary atresia Biliary hypoplasia Biliary imaging Inspissated bile syndrome Choledochal cyst

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Association of Omega-3 Polyunsaturated Fatty Acids with Sarcopenia in Liver Cirrhosis Patients with Hepatocellular Carcinoma

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Journal of Clinical and Translational hepatology 2024年第7期12卷 613-624页

作者： Akitoshi Sano Jun Inoue Eiji Kakazu Masashi Ninomiya Mio Tsuruoka Kosuke Sato Masazumi Onuki Satoko Sawahashi Keishi Ouchi Atsushi Masamune division of gastroenterology Tohoku University Graduate School of MedicineSendaiMiyagiJapan department of Liver Disease The Research Center for Hepatitis and ImmunologyNational Center for Global Health and MedicineIchikawaChibaJapan

Background and Aims:Sarcopenia is associated with the prognosis of patients with liver cirrhosis and hepatocellular carcinoma(HCC).Given their diverse physiological activities,we hypothesized that plasma fatty acids might influence the progression of *** study aimed to clarify the association between fatty acids and sarcopenia in cirrhotic patients with ***:In this singlecenter retrospective study,we registered 516 cases and analyzed 414 cases of liver cirrhosis and *** skeletal muscle mass index was measured using a transverse computed tomography scan image at the third lumbar *** cutoff value for sarcopenia followed the criteria set by the Japan Society of *** acid concentrations were measured by gas ***:Fatty acid levels,particularly omega-3(n-3)polyunsaturated fatty acid(PUFA),were lower in patients with poor liver function(Child-Pugh grade B/C)and were negatively correlated with the albumin-bilirubin score(p<0.0001).The prognosis of HCC patients with low PUFA levels was significantly *** the different fatty acid fractions,only n-3 PUFAs significantly correlated with skeletal muscle mass index(p=0.0026).In the multivariate analysis,the n-3 PUFA level was an independent variable associated with sarcopenia(p=0.0006).Conclusions:A low level of n-3 PUFAs was associated with sarcopenia in patients with liver cirrhosis and HCC.

关键词： Liver cirrhosis Hepatocellular carcinoma Sarcopenia Skeletal Muscle Fatty Acids Omega-3 polyunsaturated fatty acids

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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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Comparative associations of non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease with risk of incident chronic kidney disease:a cohort study

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Hepatobiliary Surgery and Nutrition 2024年第5期13卷 801-813,I0003-I0005页

作者： Ji Hye Heo Mi Yeon Lee Seong Hwan Kim Ming-Hua Zheng Christopher D.Byrne Giovanni Targher Ki-Chul Sung department of internal medicine Hallym University College of MedicineChuncheonRepublic of Korea division of Biostatistics Department of R&D ManagementKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea division of Cardiology Department of Internal MedicineKorea University Ansan HospitalAnsanRepublic of Korea MAFLD Research Center Department of HepatologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Wenzhou Key Laboratory of hepatology WenzhouChina Institute of hepatology Wenzhou Medical UniversityWenzhouChina Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province WenzhouChina Nutrition and Metabolism Faculty of MedicineUniversity of SouthamptonSouthamptonUK Southampton National Institute for Health and Care Research Biomedical Research CentreUniversity Hospital SouthamptonSouthamptonUK Metabolic Diseases Research Unit IRCCS Sacro Cuore-Don Calabria HospitalNegrar di ValpolicelleItaly division of Cardiology Department of Internal MedicineKangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea

Background:We examined the comparative associations between non-alcoholic fatty liver disease(NAFLD)and metabolic dysfunction-associated steatotic liver disease(MASLD)definitions with risk of developing chronic kidney disease(CKD)and abnormal ***:We conducted a cohort study of 214,145 Korean adults with normal kidney function at baseline who underwent liver *** were further subdivided into no steatotic liver disease(no-SLD),NAFLD-only,MASLD-only,both NAFLD and MASLD,and SLD not categorized as NAFLD or MASLD *** proportional hazards models were used to analyze the risk of incident CKD and ***:Compared with either the no-NAFLD or no-MASLD groups,the NAFLD and MASLD groups were associated with a higher risk of incident CKD(NAFLD:adjusted hazard ratio(HR),1.18[95%CI,1.01-1.38];MASLD:adjusted HR,1.21[95%CI,1.04-1.39]).Among the five subgroups,both NAFLD and MASLD group had the strongest association with risk of incident CKD(adjusted HR,1.21[95%CI,1.04-1.42]).The MASLD-only group had the strongest association with incident abnormal albuminuria,with an adjusted HR comparable to that of the both NAFLD and MASLD group(adjusted HR 1.96[95%CI,1.44-2.67]for the MASLD-only,and adjusted HR 1.98[95%CI,1.58-2.49]for the both NAFLD and MASLD group versus the no-SLD group).The NAFLD-only group was not independently associated with risk of CKD or abnormal ***:These findings suggest that MASLD definition identifies individuals at high risk of developing incident CKD or abnormal albuminuria better than NAFLD definition.

关键词： Metabolic dysregulation non-alcoholic fatty liver disease(NAFLD) metabolic syndrome chronic kidney disease(CKD) albuminuria

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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(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk 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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Practical approach to linear endoscopic ultrasound examination of the gallbladder

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World Journal of Radiology 2024年第6期16卷 184-195页

作者： Hussein Hassan Okasha Eyad Gadour Hassan Atalla Omar AbdAllah AbdEl-Hameed Reem Ezzat Ahmed Elsayed Alzamzamy Elsayed Ghoneem Rasha Ahmad Matar Zeinab Hassan Bogdan Miutescu Ayman Qawasmi Katarzyna M Pawlak Ahmed Elmeligui department of internal medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt department of gastroenterology and hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia department of medicine School of MedicineZamzam University CollegeKhartoum 11113Sudan department of internal medicine Hepatology and Gastroenterology UnitFaculty of MedicineMansoura UniversityMansoura 35516Egypt department of internal medicine Faculty of MedicineAssiut UniversityAssiut 71511Egypt department of gastroenterology and Heptology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11728Egypt department of gastroenterology and Advance Endoscopy Sultant Qaboos Comprehensive Cancer Care and Research CentreMuscat 0961Oman department of internal medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom department of gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Centre in gastroenterology and hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania department of gastroenterology Al-Makassed Islamic Charitable Society HospitalCairo 11124Egypt division of gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8Canada department of gastroenterology Southend University HospitalEssex SS26XTUnited Kingdom

The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging *** ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established ***,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed ***,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are ***,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive ***,EUS can serve as a supplementary tool when conventional imaging methods are *** review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.

关键词： Endoscopic ultrasound Linear endoscopic ultrasound Gallbladder anatomy Gallbladder pathologies Therapeutic endoscopic ultrasound

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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 trend<0.0001).Compared to non-septic SBS hospitalizations,septic SBS hospitalizations had a higher proportion of males(32.8%vs 29.3%,P<0.0001),patients in the 35-49(45.9%vs 42.5%,P<0.0001)and 50-64(32.1%vs 31.1%,P<0.0001)age groups,and ethnic minorities,i.e.,Blacks(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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