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严重吞咽困难对经皮内镜下胃造口术后总生存期的影响。

Impact of severe dysphagia on overall survival after percutaneous endoscopic gastrostomy.

作者信息

Shimamoto Kazumi, Matsui Ryota, Nishiyama Yorihiro, Nishino Kyohei, Ban Hiromitsu

机构信息

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.

出版信息

Sci Rep. 2025 Jan 29;15(1):3617. doi: 10.1038/s41598-025-88097-y.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1528/11775191/1f484cca0efb/41598_2025_88097_Fig1_HTML.jpg

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