Correia João, Pinho Rolando, Rodrigues Adélia, Ponte Ana, Gomes Catarina, Afecto Edgar, Estevinho Manuela, Freitas Teresa
Serviço de Gastrenterologia, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal.
GE Port J Gastroenterol. 2022 May 20;30(5):336-342. doi: 10.1159/000524268. eCollection 2023 Oct.
This study aimed to evaluate the effect of small-bowel angioectasia on survival, given the hypothesis that angioectasia might be an independent risk factor of frailty and poor outcomes.
In this retrospective cohort study, all patients undergoing small-bowel capsule endoscopy between 2010 and 2013 for obscure gastrointestinal bleeding from a Portuguese tertiary centre were included. Follow-up started after capsule endoscopy and ended upon death or end of the study (November 2020). Survival analysis was performed using a Cox proportional-hazards model, in order to analyse the effect of small-bowel angioectasia on survival as well as potentially confounding factors (age, vascular diseases and chronic kidney disease).
A total of 176 patients were included in this study (50.6% male), with a median age of 68.5 years (IQR 24). The median follow-up was 7 years (IQR 4), during which 67 (38.1%) patients died. Seventy-three (41.5%) patients had at least one small-bowel angioectasia on capsule endoscopy. On multivariate Cox regression analysis, only age, peripheral arterial disease, history of previous mesenteric ischaemia and chronic kidney disease were independent risk factors of death. The presence of small-bowel angioectasia did not affect survival in this analysis (HR 1.30; 95% CI 0.75-2.23; = 0.35).
In this retrospective cohort study, some comorbidities and age were independent predictors of poor survival. The presence of small-bowel angioectasia per se did not affect survival.
本研究旨在评估小肠血管扩张对生存的影响，基于血管扩张可能是虚弱和不良预后的独立危险因素这一假设。
在这项回顾性队列研究中，纳入了2010年至2013年间在葡萄牙一家三级中心因不明原因胃肠道出血接受小肠胶囊内镜检查的所有患者。随访从胶囊内镜检查后开始，至死亡或研究结束（2020年11月）。使用Cox比例风险模型进行生存分析，以分析小肠血管扩张对生存的影响以及潜在的混杂因素（年龄、血管疾病和慢性肾脏病）。
本研究共纳入176例患者（男性占50.6%），中位年龄为68.5岁（四分位间距为24）。中位随访时间为7年（四分位间距为4），在此期间67例（38.1%）患者死亡。73例（41.5%）患者在胶囊内镜检查中至少有一处小肠血管扩张。在多变量Cox回归分析中，只有年龄、外周动脉疾病、既往肠系膜缺血病史和慢性肾脏病是死亡的独立危险因素。在该分析中，小肠血管扩张的存在并未影响生存（风险比1.30；95%置信区间0.75 - 2.23；P = 0.35）。
在这项回顾性队列研究中，一些合并症和年龄是生存不良的独立预测因素。小肠血管扩张本身的存在并未影响生存。
