Lee Sean, Ghosh Abheek, Raymond Aislynn, Akhter Nabeel M
Department of Diagnostic Radiology, Touro College, Middletown, United States.
Department of Radiology, University of Maryland, Baltimore, United States.
J Clin Imaging Sci. 2024 Jan 12;14:1. doi: 10.25259/JCIS_62_2023. eCollection 2024.
The aim of our study was to determine if patients with obesity have different postoperative outcomes than their peers.
A single-center retrospective review of all fluoroscopically-guided percutaneous gastrostomy tube, with 183 patients and 90 patients in the BAG and dilator groups, respectively. Patients were stratified, based on body mass index (BMI) percentile and for age. Demographic information and data on medical comorbidities and post-operative complications were collected. All analyses were conducted using Chi-square or Kruskal-Wallis testing.
The median BMI was 26.6 kg/m with a standard deviation of 7.7. 106 (38.8%) patients were classified in the normal BMI category, 57 (20.9%) were overweight, and 50 (28.3%) were classified as obese. No major complications were reported in either group. 106 patients (38.8%) reported minor complications. The most common complication observed across both groups was procedural pain, with a higher incidence in the balloon group compared to the dilator group (17.5% vs. 12.2%). Dislodgement emerged as the second most common complication, occurring more frequently in the balloon group (12%) compared to the dilator group (6.7%). When considering weight categories, the overall rate of minor complications was highest among underweight patients (57.6%, = 0.124). Both underweight and normal BMI patients showed a significantly higher incidence of tube dislodgement compared to other BMI categories (27.2% and 9.4%, respectively, = 0.015). In a multivariable logistic regression, age was associated with an increased risk of minor complications (odds ratio [OR] 1.03, F [1.01, 1.05], = 0.002). BAG had a greater OR for minor complication rate compared to dilator-assisted gastrostomy, although the difference was not statistically significant (OR 1.19, 95% confidence interval [0.69, 2.06]).
Few studies have identified the relationship between BMI and complications related to gastrostomy tube placement. Our study highlights the importance of individualized care for patients across different BMI classes to minimize complications and improve patient outcomes.
我们研究的目的是确定肥胖患者与同龄人相比术后结局是否不同。
对所有在荧光镜引导下经皮胃造口管进行单中心回顾性研究，气囊组和扩张器组分别有183例和90例患者。根据体重指数（BMI）百分位数和年龄对患者进行分层。收集人口统计学信息以及有关合并症和术后并发症的数据。所有分析均使用卡方检验或克鲁斯卡尔 - 沃利斯检验。
BMI中位数为26.6kg/m²，标准差为7.7。106例（38.8%）患者属于正常BMI类别，57例（20.9%）超重，50例（28.3%）被归类为肥胖。两组均未报告重大并发症。106例患者（38.8%）报告有轻微并发症。两组中观察到的最常见并发症是操作过程中的疼痛，气囊组的发生率高于扩张器组（17.5%对12.2%）。移位是第二常见的并发症，气囊组的发生率高于扩张器组（12%对6.7%）。在考虑体重类别时，体重过轻患者的轻微并发症总体发生率最高（57.6%，P = 0.124）。与其他BMI类别相比，体重过轻和正常BMI的患者管移位发生率显著更高（分别为27.2%和9.4%，P = 0.015）。在多变量逻辑回归中，年龄与轻微并发症风险增加相关（比值比[OR]为1.03，F[1.01, 1.05]，P = 0.002）。与扩张器辅助胃造口术相比，气囊胃造口术的轻微并发症发生率的OR值更大，尽管差异无统计学意义（OR为1.19，95%置信区间[0.69, 2.06]）。
很少有研究确定BMI与胃造口管置入相关并发症之间的关系。我们的研究强调了对不同BMI类别的患者进行个体化护理以尽量减少并发症并改善患者结局的重要性。
