Duffey Katherine, Hannon Michelle, Yoo Joseph, Perkons Nicholas, Intenzo Charles, Moleski Stephanie, DiMarino Anthony J
Department of Medicine, Division of Internal Medicine, Thomas Jefferson University Hospital, Philadelphia, PA (Katherine Duffey, Michelle Hannon).
Department of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA (Joseph Yoo, Stephanie Moleski, Anthony J. DiMarino).
Ann Gastroenterol. 2020 May-Jun;33(3):250-256. doi: 10.20524/aog.2020.0475. Epub 2020 Apr 2.
Gastroparesis is a complex and poorly understood disease. The literature is lacking with respect to the epidemiology of patient comorbidities and their effect on gastric emptying. We aimed to describe the most common comorbid conditions among patients with gastroparesis in an urban population and quantify the effect of these comorbidities on the severity of delayed gastric emptying (DGE).
We examined the medical records of all patients diagnosed with gastroparesis at a quaternary care center between 2014 and 2015. The severity of DGE was analyzed after patients were stratified for possible causative etiologies. Likelihood ratio tests were used to assess the significance of demographic and scintigraphic variation in this population.
Of the 221 patients, 56.1% were Caucasian and 31.7% were African American. Among these patients, 29.4% had evidence of medication-associated gastroparesis, 29.0% had diabetes-associated gastroparesis, and 31.7% had idiopathic disease. African American patients with gastroparesis were more likely to have diabetic gastroparesis than patients of other races (P=0.01). There was a statistically significant relationship between the number of major risk factors and the severity of a patient's DGE (P=0.004).
Among a diverse urban population, patients with DGE often carry multiple comorbid conditions that serve as risk factors for the development of gastroparesis, including prescriptions for narcotic medications. Greater numbers of these comorbid conditions are associated with more severe disease. Demographics are significantly associated with the etiology and severity of gastroparesis; in particular, African American patients are more likely to have diabetic gastroparesis than patients of other races.
胃轻瘫是一种复杂且了解甚少的疾病。关于患者合并症的流行病学及其对胃排空的影响,文献资料匮乏。我们旨在描述城市人群中胃轻瘫患者最常见的合并症,并量化这些合并症对胃排空延迟(DGE)严重程度的影响。
我们查阅了2014年至2015年期间在一家四级医疗中心被诊断为胃轻瘫的所有患者的病历。在对患者进行可能的病因分层后,分析了DGE的严重程度。采用似然比检验来评估该人群中人口统计学和闪烁扫描变化的显著性。
在221例患者中,56.1%为白种人,31.7%为非裔美国人。在这些患者中,29.4%有药物相关性胃轻瘫的证据,29.0%有糖尿病相关性胃轻瘫,31.7%患有特发性疾病。与其他种族的患者相比,非裔美国胃轻瘫患者更易患糖尿病性胃轻瘫(P = 0.01)。主要危险因素的数量与患者DGE的严重程度之间存在统计学显著关系(P = 0.004)。
在多样化的城市人群中,DGE患者常伴有多种合并症,这些合并症是胃轻瘫发生的危险因素,包括麻醉药物处方。这些合并症数量越多,疾病越严重。人口统计学与胃轻瘫的病因和严重程度显著相关;特别是,非裔美国患者比其他种族的患者更易患糖尿病性胃轻瘫。