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经皮内镜下胃造口术后患者早期出院及死亡的预测因素

Factors predicting early discharge and mortality in post-percutaneous endoscopic gastrostomy patients.

作者信息

Gumaste Vivek V, Bhamidimarri Kalyan R, Bansal Raghav, Sidhu Lovleen, Baum Joel, Walfish Aaron

机构信息

Department of Medicine, Mount Sinai Services, City Hospital Center at Elmhurst, New York and the Mount Sinai School of Medicine of the City University of New York, USA.

出版信息

Ann Gastroenterol. 2014;27(1):42-47.

Abstract

BACKGROUND

The aim of our study was to ascertain factors that favor early discharge and predict mortality in post-percutaneous endoscopic gastrostomy (PEG) patients.

METHODS

Successive patients who underwent successful PEG placement during a 10-year period in a single New York City hospital were included in the study. Data was retrospectively extracted from hospital electronic medical records.

RESULTS

Two hundred and eighty-four patients underwent successful PEG placement. Forty-six patients (16%) were discharged within 3 days of PEG placement (early discharge). Two hundred and thirty six patients (84%) remained in hospital from 4 to 244 days (median 13.5) after PEG insertion (late discharge). Twenty-six (9%) patients died in-house after PEG placement. A serum albumin level <2.2 g/dL (P0.007) and presence of 2 or more co-morbidities (P0.019) were predictors of late discharge. A dementia indication was twice as likely to result in an early discharge compared to a stroke indication (OR 2.39; 95% CI 1.07-5.36; P=0.033). Female sex, positive urine cultures and low serum albumin levels were independent predictors of in-house mortality.

CONCLUSION

Clinical and laboratory markers may predict post-PEG mortality as well as early patient discharge.

摘要

背景

我们研究的目的是确定有利于经皮内镜下胃造口术(PEG)术后患者早期出院的因素,并预测其死亡率。

方法

纳入在纽约市一家医院10年间成功进行PEG置管的连续患者。数据从医院电子病历中回顾性提取。

结果

284例患者成功进行了PEG置管。46例患者(16%)在PEG置管后3天内出院(早期出院)。236例患者(84%)在PEG置管后4至244天(中位数13.5天)住院(延迟出院)。26例(9%)患者在PEG置管后院内死亡。血清白蛋白水平<2.2 g/dL(P<0.007)和存在2种或更多合并症(P<0.019)是延迟出院的预测因素。与中风指征相比,痴呆指征导致早期出院的可能性是中风指征的两倍(比值比2.39;95%置信区间1.07 - 5.36;P = 0.033)。女性、尿培养阳性和低血清白蛋白水平是院内死亡的独立预测因素。

结论

临床和实验室指标可预测PEG术后死亡率以及患者早期出院情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d73/3959526/a655b9e0c874/AnnGastroenterol-27-42-g001.jpg

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