共查询到20条相似文献,搜索用时 15 毫秒
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Monika Laszkowska Adam S. Faye Judith Kim Han Truong Elisabeth R. Silver Myles Ingram Benjamin May Benjamin Ascherman Logan Bartram Jason Zucker Magdalena E. Sobieszczyk Julian A. Abrams Benjamin Lebwohl Daniel E. Freedberg Chin Hur 《Clinical gastroenterology and hepatology》2021,19(7):1402-1409.e1
Background & AimsOur understanding of outcomes and disease time course of COVID-19 in patients with gastrointestinal (GI) symptoms remains limited. In this study we characterize the disease course and severity of COVID-19 among hospitalized patients with gastrointestinal manifestations in a large, diverse cohort from the Unites States.MethodsThis retrospective study evaluated hospitalized individuals with COVID-19 between March 11 and April 28, 2020 at two affiliated hospitals in New York City. We evaluated the association between GI symptoms and death, and also explored disease duration, from symptom onset to death or discharge.ResultsOf 2804 patients hospitalized with COVID-19, the 1,084 (38.7%) patients with GI symptoms were younger (aOR for age ≥75, 0.59; 95% CI, 0.45-0.77) and had more co-morbidities (aOR for modified Charlson comorbidity score ≥2, 1.22; 95% CI, 1.01-1.48) compared to those without GI symptoms. Individuals with GI symptoms had better outcomes, with a lower likelihood of intubation (aHR, 0.66; 95% CI, 0.55-0.79) and death (aHR, 0.71; 95% CI, 0.59-0.87), after adjusting for clinical factors. These patients had a longer median disease course from symptom onset to discharge (13.8 vs 10.8 days, log-rank p = .048; among 769 survivors with available symptom onset time), which was driven by longer time from symptom onset to hospitalization (7.4 vs 5.4 days, log-rank P < .01).ConclusionHospitalized patients with GI manifestations of COVID-19 have a reduced risk of intubation and death, but may have a longer overall disease course driven by duration of symptoms prior to hospitalization. 相似文献
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Eun Soo Kim Leonid Tarassishin Caroline Eisele Amelie Barre Nilendra Nair Alexa Rendon Kelly Hawkins Anketse Debebe Sierra White Anne Thjømøe Einar Mørk Mario Bento-Miranda Hinaben Panchal Manasi Agrawal Anish Patel Ching-Lynn Chen Asher Kornbluth James George Jianzhong Hu 《Gastroenterology》2021,160(4):1118-1130.e3
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Donghee Kim Nia Adeniji Nyann Latt Sonal Kumar Patricia P. Bloom Elizabeth S. Aby Ponni Perumalswami Marina Roytman Michael Li Alexander S. Vogel Andreea M. Catana Kara Wegermann Rotonya M. Carr Costica Aloman Vincent L. Chen Atoosa Rabiee Brett Sadowski Veronica Nguyen Renumathy Dhanasekaran 《Clinical gastroenterology and hepatology》2021,19(7):1469-1479.e19
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《Clinical gastroenterology and hepatology》2022,20(5):e1006-e1021
Background & AimsWe aimed to perform geriatric assessment in older patients with inflammatory bowel disease (IBD) to evaluate which IBD characteristics associate with deficits in geriatric assessment and the impact of deficits on disease burden (health-related quality of life).MethodsA prospective multicenter cohort study including 405 consecutive outpatient patients with IBD aged ≥65 years. Somatic domain (comorbidity, polypharmacy, malnutrition), impairments in (instrumental) activities of daily living, physical capacity (handgrip strength, gait speed), and mental (depressive symptoms, cognitive impairment) and social domain (life-partner) were assessed. Deficits in geriatric assessment were defined as ≥2 abnormal domains; 2–3 moderate deficits and 4–5 severe deficits. Clinical (Harvey Bradshaw Index >4/partial Mayo Score >2) and biochemical (C-reactive protein ≥10 mg/L and/or fecal calprotectin ≥250 μg/g) disease activity and disease burden (short Inflammatory Bowel Disease Questionnaire) were assessed.ResultsSomatic domain (51.6%) and activities of daily living (43.0%) were most frequently impaired. A total of 160 (39.5%) patients had moderate deficits in their geriatric assessment; 32 (7.9%) severe. Clinical and biochemical disease activity associated with deficits (clinical: adjusted odds ratio, 2.191; 95% confidence interval, 1.284–3.743; P = .004; biochemical: adjusted odds ratio, 3.358; 95% confidence interval, 1.936–5.825; P < .001). Deficits in geriatric assessment independently associate with lower health-related quality of life.ConclusionDeficits in geriatric assessment are highly prevalent in older patients with IBD. Patients with active disease are more prone to deficits, and deficits associate with lower health-related quality of life, indicating higher disease burden. Prospective data validating impact of frailty and geriatric assessment on outcomes are warranted to further improve treatment strategies. 相似文献
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