Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
Dig Dis Sci. 2013 Jun;58(6):1668-75. doi: 10.1007/s10620-012-2536-2. Epub 2013 Jan 13.
To explore the predictive factors of cardiorespiratory abnormality in nonsedated patients at high altitude (HA) during upper gastrointestinal endoscopy (UGIE).
The pulse and saturated oxygen (SaO2) levels of 993 patients undergoing nonsedated UGIE in Tibet were monitored. Bivariate correlation and logistic regression were used to identify predictive risk factors for hypoxemia.
The basal and minimum SaO2 levels during UGIE of the Tibetan group were significantly higher than those of the non-Tibetan group. The minimum SaO2 and maximum pulse in the HA transient residents groups were significantly higher than those in the HA usual residents groups. The incidences of hypoxemia and severe hypoxemia in the Tibetan groups were significantly lower than those of the non-Tibetan groups. Bivariate correlation and logistic regression showed that race, age (≥ 40 years), residence time in HA (<10 years), and basal SaO2 (<89 %) were sufficiently effective to predict hypoxemia. High-risk hypoxemic patients whose residence time in HA was <2 years were more prone to severe hypoxemia. The combination of the four variables showed superior performance in hypoxemia prognosis (AUC-ROC, 0.941; sensitivity, 83.7 %; specificity, 92.5 %) and severe hypoxemia prognosis (AUC-ROC, 0.968; sensitivity, 90.3 %; specificity, 98.0 %).
Race, age, residence time in HA, and basal SaO2 of patients in HA were predictive variables for hypoxemia during UGIE. Non-Tibetan patients with age ≥ 40 years, residence time in HA <10 years, and basal SaO2 <89 % were prone to hypoxemia. Among those groups, patients whose residence time was <2 years were at higher risk for severe hypoxemia.
探讨非镇静患者在高原（HA）上行上消化道内镜检查（UGIE）时心肺异常的预测因素。
监测了 993 例在西藏接受非镇静性 UGIE 的患者的脉搏和血氧饱和度（SaO2）水平。采用双变量相关和逻辑回归分析来确定低氧血症的预测风险因素。
藏族组 UGIE 时的基础和最低 SaO2 水平明显高于非藏族组。高原临时居民组的最低 SaO2 和最大脉搏明显高于高原常住居民组。藏族组的低氧血症和严重低氧血症发生率明显低于非藏族组。双变量相关和逻辑回归分析显示，种族、年龄（≥40 岁）、高原居住时间（<10 年）和基础 SaO2（<89%）是预测低氧血症的有效因素。高原居住时间<2 年的高危低氧血症患者更容易发生严重低氧血症。四项变量的组合在低氧血症预后（AUC-ROC，0.941；敏感性，83.7%；特异性，92.5%）和严重低氧血症预后（AUC-ROC，0.968；敏感性，90.3%；特异性，98.0%）方面表现出优异的性能。
患者的种族、年龄、高原居住时间和基础 SaO2 是 UGIE 期间低氧血症的预测变量。年龄≥40 岁、高原居住时间<10 年、基础 SaO2<89%的非藏族患者易发生低氧血症。在这些人群中，居住时间<2 年的患者发生严重低氧血症的风险更高。
