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- 저자 : Tatsuya Matsuno (검색결과 2 건)
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Risk Factors for Prolonged Hospital Stay after Endoscopy
Toshihiro Nishizawa,Shuntaro Yoshida,Osamu Toyoshima,Tatsuya Matsuno,Masataka Irokawa,Toru Arano,Hirotoshi Ebinuma,Hidekazu Suzuki,Takanori Kanai,Kazuhiko Koike 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.6
Background/Aims: The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unitis desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay amongoutpatients. Methods: We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at theToyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depressionduring endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100minutes) were identified using multiple logistic regression analysis. Results: We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested withoutsedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and nonsedationgroup was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025;95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI,1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results forcolonoscopy. Conclusions: Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.
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Yuji Maehata,Yutaka Nagata,Tomohiko Moriyama,Yuichi Matsuno,Atsushi Hirano,Junji Umeno,Takehiro Torisu,Tatsuya Manabe,Takanari Kitazono,Motohiro Esaki 대한장연구학회 2019 Intestinal Research Vol.17 No.3
Background/Aims: It remains uncertain which patients with stricturing-type Crohn’s disease (CD) require early small bowel surgery after the initial diagnosis. We aimed to clarify clinical characteristics associated with the intervention in such condition of CD. Methods: We retrospectively evaluated the clinical course of 53 patients with CD and small bowel strictures who were initially treated with medications after the initial diagnosis. We investigated possible associations between small bowel surgery and the following: clinical factors and radiologic findings at initial diagnosis and the types of medications administered during follow-up. Results: Twenty-eight patients (53%) required small bowel resection during a median follow-up period of 5.0 years (range, 0.5–14.3 years). The cumulative incidence rates of small bowel surgery at 2, 5, and 10 years were 26.4%, 41.0%, and 63.2%, respectively. Univariate analysis indicated that obstructive symptoms (P=0.036), long-segment stricture (P<0.0001), and prestenotic dilation (P<0.0001) on radiography were associated with small bowel surgery, and immunomodulatory (P=0.037) and biological therapy (P=0.008) were significant factors during follow-up. Multivariate analysis revealed that long-segment stricture (hazard ratio [HR], 4.25; 95% confidence interval [CI], 1.78–10.53; P=0.001) and prestenotic dilation (HR, 3.41; 95% CI, 1.24–9.62; P=0.018) on radiography showed a positive correlation with small bowel surgery, and biological therapy (HR, 0.40; 95% CI, 0.15–0.99; P=0.048) showed a negative correlation. Conclusions: CD patients with long-segment stricture and prestenotic dilation on radiography seem to be at a higher risk of needing small bowel surgery. For such patients, early surgical intervention might be appropriate, even at initial diagnosis.
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