Wijarnpreecha Karn, Sornprom Suthanya, Thongprayoon Charat, Phatharacharukul Parkpoom, Cheungpasitporn Wisit, Nakkala Kiran
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
Dig Liver Dis. 2016 May;48(5):468-472. doi: 10.1016/j.dld.2016.01.012. Epub 2016 Feb 4.
BACKGROUND/OBJECTIVES: Clostridium difficile-associated diarrhea (CDAD) is a major concern of public health worldwide. The risk of CDAD in patients with nasogastric tube (NGT) insertion is controversial. The aim of this study was to assess the risk of incidence of CDAD in patients with NGT insertion.
A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through August 2015. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of CDAD in patients with NGT insertion versus those who did not were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.
Eleven observational studies were included in our analysis to assess the association between NGT insertion and risk of CDAD. The pooled RR of CDAD in patients with NGT insertion was 1.87 (95% CI, 1.06-3.28, I(2)=73). When meta-analysis was limited only to cohort and case-control studies, the pooled RR of CDAD was 1.99 (95% CI, 1.05-3.77, I(2)=76).
Our study demonstrated a statistically significant association between NGT insertion and risk of CDAD. This finding may impact clinical management and primary prevention of CDAD.
背景/目的：艰难梭菌相关性腹泻（CDAD）是全球公共卫生领域的一个主要问题。鼻胃管（NGT）插入患者发生CDAD的风险存在争议。本研究的目的是评估NGT插入患者发生CDAD的风险。
使用MEDLINE、EMBASE和Cochrane系统评价数据库进行文献检索，检索时间从建库至2015年8月。纳入报告了比较NGT插入患者与未插入患者CDAD风险的相对风险、比值比或风险比的研究。采用随机效应、通用逆方差法计算合并风险比（RR）和95%置信区间（CI）。
11项观察性研究纳入我们的分析，以评估NGT插入与CDAD风险之间的关联。NGT插入患者CDAD的合并RR为1.87（95%CI，1.06 - 3.28，I² = 73）。当荟萃分析仅限于队列研究和病例对照研究时，CDAD的合并RR为1.99（95%CI，1.05 - 3.77，I² = 76）。
我们的研究表明NGT插入与CDAD风险之间存在统计学上的显著关联。这一发现可能会影响CDAD的临床管理和一级预防。
