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日本全国住院患者数据库研究:儿童患者行肝穿刺活检后出现的主要并发症:原发性或移植肝脏。

Major complications after percutaneous biopsy of native or transplanted liver in pediatric patients: a nationwide inpatient database study in Japan.

机构信息

Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

Department of Pediatrics, National Rehabilitation Center for Persons With Disabilities, Saitama, Japan.

出版信息

BMC Gastroenterol. 2022 Aug 24;22(1):395. doi: 10.1186/s12876-022-02476-7.

Abstract

AIM

Although major complication rates following percutaneous liver biopsy (PLB) have been reported to be higher in children than in adults, scarce data are available regarding pediatric patients stratified by native and transplanted liver. We aimed to assess the factors associated with major complications after percutaneous biopsy of native or transplanted liver using a nationwide inpatient database.

METHODS

Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified pediatric patients who underwent PLB between 2010 and 2018. We described major complication rates and analyzed factors associated with major complications following PLB, stratified by native and transplanted liver.

RESULTS

We identified 3584 pediatric PLBs among 1732 patients from 239 hospitals throughout Japan during the study period, including 1310 in the native liver and 2274 in the transplanted liver. Major complications following PLB were observed in 0.5% (n = 18) of the total cases; PLB in the transplanted liver had major complications less frequently than those in the native liver (0.2% vs. 1.0%, p = 0.002). The occurrence of major complications was associated with younger age, liver cancers, unscheduled admission, anemia or coagulation disorders in cases with native liver, while it was associated with younger age alone in cases with transplanted liver.

CONCLUSIONS

The present study, using a nationwide database, found that major complications occurred more frequently in pediatric cases with native liver and identified several factors associated with its major complications.

摘要

目的

尽管经皮肝活检(PLB)后的主要并发症发生率在儿童中高于成人,但关于按原肝和移植肝分层的儿科患者的数据很少。我们旨在使用全国住院患者数据库评估经皮活检原肝和移植肝后发生主要并发症的相关因素。

方法

使用日本诊断程序组合数据库,我们回顾性地确定了 2010 年至 2018 年间接受 PLB 的儿科患者。我们描述了主要并发症的发生率,并分析了 PLB 后与主要并发症相关的因素,按原肝和移植肝分层。

结果

在研究期间,我们从日本 239 家医院的 1732 名患者中确定了 3584 例儿科 PLB,包括 1310 例原肝和 2274 例移植肝。PLB 后观察到 0.5%(n=18)的总病例中存在主要并发症;移植肝的 PLB 发生主要并发症的频率低于原肝(0.2%比 1.0%,p=0.002)。原肝发生主要并发症与年龄较小、肝癌、非计划性入院、贫血或凝血障碍有关,而移植肝仅与年龄较小有关。

结论

本研究使用全国数据库发现,原肝儿科患者发生主要并发症的频率更高,并确定了与主要并发症相关的几个因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6508/9404589/ea707f5a1d71/12876_2022_2476_Fig1_HTML.jpg

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