肥胖与胃轻瘫住院难题：美国社会经济和种族背景下住院特征及差异的回顾性比较分析

The Conundrum of Obesity and Gastroparesis Hospitalizations: A Retrospective Comparative Analysis of Hospitalization Characteristics and Disparities Amongst Socioeconomic and Racial Backgrounds in the United States.

作者信息

Dahiya Dushyant S, Inamdar Sumant, Perisetti Abhilash, Goyal Hemant, Singh Amandeep, Garg Rajat, Cheng Chin-I, Kichloo Asim, Al-Haddad Mohammad, Sharma Neil

机构信息

Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI, USA.

Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

J Neurogastroenterol Motil. 2022 Oct 30;28(4):655-663. doi: 10.5056/jnm21232.

DOI:10.5056/jnm21232

PMID:36250372

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9577565/

Abstract

BACKGROUND/AIMS: We aim to assess the influence of obesity on gastroparesis (GP) hospitalizations in the United States (US).

METHODS

The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of GP. They were subdivided based on the presence or absence of obesity (body mass index > 30). Hospitalization characteristics, procedural differences, all-cause inpatient mortality, mean length of stay (LOS), and mean total hospital charge (THC) were identified and compared.

RESULTS

From 2007-2017, there were 140 293 obese GP hospitalizations accounting for 13.75% of all GP hospitalizations in the US. Obese GP hospitalizations were predominantly female (76.11% vs 64.36%, < 0.001) and slightly older (51.9 years vs 50.8 years, < 0.001) compared to the non-obese cohort. Racial disparities were noted as Blacks (25.49% vs 22%, < 0.001) had higher proportions of GP hospitalizations with obesity compared to the non-obese cohort. Furthermore, we noted higher rates of inpatient upper endoscopy utilization (6.05% vs 5.42%, < 0.001), longer mean LOS (5.71 days vs 5.32 days, < 0.001), and higher mean THC ($53 373 vs $45 040, < 0.001) for obese GP hospitalizations compared to the non-obese group. However, obese GP hospitalizations had lower rates of inpatient mortality (0.92% vs 1.33%, < 0.001), and need for nutritional support with endoscopic jejunostomy (0.25 vs 0.56%, < 0.001) and total parenteral nutrition (1.46% vs 2.33%, < 0.001) compared to the non-obese cohort.

CONCLUSIONS

In the US, compared to non-obese, a higher proportion of obese GP hospitalizations were female and Blacks. Obese GP hospitalizations also had higher THC, LOS, and rates of upper endoscopy.

摘要

背景/目的：我们旨在评估肥胖对美国胃轻瘫（GP）住院情况的影响。

方法

对2007年至2017年的全国住院患者样本进行分析，以确定所有主要出院诊断为胃轻瘫的成年住院患者。根据是否存在肥胖（体重指数>30）将他们进行细分。确定并比较住院特征、手术差异、全因住院死亡率、平均住院时间（LOS）和平均总住院费用（THC）。

结果

2007年至2017年，美国有140293例肥胖胃轻瘫住院患者，占所有胃轻瘫住院患者的13.75%。与非肥胖队列相比，肥胖胃轻瘫住院患者以女性为主（76.11%对64.36%，<0.001），且年龄稍大（51.9岁对50.8岁，<0.001）。种族差异显著，与非肥胖队列相比，黑人肥胖胃轻瘫住院患者的比例更高（25.49%对22%，<0.001）。此外，我们注意到肥胖胃轻瘫住院患者的住院上消化道内镜检查使用率更高（6.05%对5.42%，<0.001），平均住院时间更长（5.71天对5.32天，<0.001），平均总住院费用更高（53373美元对45040美元，<0.001）。然而，与非肥胖队列相比，肥胖胃轻瘫住院患者的住院死亡率较低（0.92%对1.33%，<0.001），内镜空肠造口术营养支持需求较低（0.25对0.56%，<0.001），全胃肠外营养需求较低（1.46%对2.33%，<0.001）。