Shimamoto Kazumi, Matsui Ryota, Nishiyama Yorihiro, Nishino Kyohei, Ban Hiromitsu
Department of Gastroenterology, Omi Medical Center, 1660 Yabase-cho, Kusatsu, 525- 8585, Shiga, Japan.
Department of Gastroenterological Surgery, The Cancer Institute Hospital of JFCR, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Sci Rep. 2025 Jan 29;15(1):3617. doi: 10.1038/s41598-025-88097-y.
In this study, we investigated the effect of severe dysphagia on the overall survival of patients who underwent PEG. A cohort of patients who underwent PEG between April 2016 and April 2021 was retrospectively analyzed. The Hyodo-Komagane score was used to evaluate swallowing via endoscopy. Patients with a Hyodo-Komagane score ≤ 8 were defined as having moderate dysphagia, whereas those with a score ≥ 9 were defined as having severe dysphagia. The primary outcome was overall survival. The prognostic factors were identified using multivariate analysis with the Cox proportional hazards model. Values of p < 0.05 were considered statistically significant. Among the 107 patients, 60 (56.1%) were classified into the moderate dysphagia group and 47 (43.9%) into the severe dysphagia group. The median follow-up period was 16.7 months. The overall survival was significantly worse in the severe group than in the moderate group (p < 0.0001). A multivariate analysis revealed that severe dysphagia was an independent poor prognostic factor (hazard ratio, 2.956; 95% confidence interval, 1.592-5.489; p < 0.001). Aspiration-related pneumonia was most common causes of death after PEG. Severe dysphagia was identified as an independent poor prognostic factor for survival in patients who underwent PEG.
在本研究中，我们调查了严重吞咽困难对接受经皮内镜下胃造口术（PEG）患者总生存期的影响。对2016年4月至2021年4月期间接受PEG的一组患者进行了回顾性分析。使用Hyodo-Komagane评分通过内镜评估吞咽情况。Hyodo-Komagane评分≤8分的患者被定义为中度吞咽困难，而评分≥9分的患者被定义为严重吞咽困难。主要结局是总生存期。使用Cox比例风险模型进行多变量分析以确定预后因素。p<0.05的值被认为具有统计学意义。在107例患者中，60例（56.1%）被归类为中度吞咽困难组，47例（43.9%）被归类为严重吞咽困难组。中位随访期为16.7个月。严重组的总生存期明显差于中度组（p<0.0001）。多变量分析显示，严重吞咽困难是一个独立的不良预后因素（风险比，2.956；95%置信区间，1.592 - 5.489；p<0.001）。误吸相关性肺炎是PEG术后最常见的死亡原因。严重吞咽困难被确定为接受PEG患者生存的独立不良预后因素。
