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RISS 인기검색어
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- 저자 : Hemant Goyal (검색결과 3 건)
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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States
Dushyant Singh Dahiya,Abhilash Perisetti,Hemant Goyal,Sumant Inamdar,Amandeep Singh,Rajat Garg,Chin-I Cheng,Mohammad Al-Haddad,Madhusudhan R. Sanaka,Neil Sharma 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3
Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States. Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared. Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p<0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management. Conclusions: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.
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Dushyant S Dahiya,Sumant Inamdar,Abhilash Perisetti,Hemant Goyal,Amandeep Singh,Rajat Garg,Chin-I Cheng,Asim Kichloo,Mohammad Al-Haddad,Neil Sharma 대한소화기 기능성질환∙운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.4
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%, P < 0.001) and slightly older (51.9 years vs 50.8 years, P < 0.001) compared to the non-obese cohort. Racial disparities were noted as Blacks (25.49% vs 22%, P < 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%, P < 0.001), longer mean LOS (5.71 days vs 5.32 days, P < 0.001), and higher mean THC ($53 373 vs $45 040, P < 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%, P < 0.001), and need for nutritional support with endoscopic jejunostomy (0.25 vs 0.56%, P < 0.001) and total parenteral nutrition (1.46% vs 2.33%, P < 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.
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Rupak Desai,Upenkumar Patel,Shreyans Doshi,Dipen Zalavadia,Wardah Siddiq,Hitanshu Dave,Mohammad Bilal,Vikas Khullar,Hemant Goyal,Madhav Desai,Nihar Shah 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5
Background/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (Julyto September) and later (October to June) academic months to assess the “July effect”. Methods: The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teachinghospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluatethe odds of post-ERCP sepsis and its predictors. Results: Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academicmonths. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higherincidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during theearly academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients withpost-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications suchas cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis inprocedures performed during the early academic months. Conclusions: The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into considerationthe predictors of post-ERCP sepsis to lower health-care burden.
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