Scholarlink

Background <p>Patients with esophageal motility disorders (EMDs) sometimes develop bacterial pneumonia (BP). However, factors associated with BP in patients with EMDs and whether peroral endoscopic myotomy (POEM) reduces BP development are unclear. Therefore, this study aimed to identify factors associated with BP development and evaluate the preventive potential of POEM in patients with EMDs.</p> Methods <p>This study included 623 patients diagnosed with EMDs at our institution between April 2015 and March 2023. Factors associated with BP were analyzed by comparing characteristics between patients who developed BP within 1&#xa0;year before diagnosis using multivariable analysis. The potential of POEM to prevent BP development was assessed using Cox regression analysis, considering treatment status as a time-varying covariate.</p> Results <p>Of the 623 patients, 31 (5.0%) developed BP within 1&#xa0;year before diagnosis. Older age (odds ratio [OR] = 1.29, 95% confidence interval [CI] 1.04–1.59, <i>p</i> = 0.019; 10-year increments), lower body mass index (OR = 0.87, 95% CI 0.78–0.98, <i>p</i> = 0.026), and manometric diagnosis of spastic esophageal disorders (OR = 2.97, 95% CI 1.24–7.16, <i>p</i> = 0.015) were significantly associated with BP. Treatment status of POEM was proved to be a significant factor for developing BP using Cox regression analysis (hazard ratio = 0.17, 95% CI 0.039–0.75, <i>p</i> = 0.019).</p> Conclusions <p>Risk factors associated with BP in patients with EMDs were older age, lower body mass index, and manometric diagnosis of spastic esophageal disorders. POEM could decrease spasm-related bolus reflux, improve patients’ nutritional status through resolution of transit disturbance, and reduce respiratory complications, suggesting that POEM could help prevent BP development.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Factors associated with the development of bacterial pneumonia and the preventive potential of peroral endoscopic myotomy in patients with esophageal motility disorders: a case–control study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月24日

查看全文
  • Hitomi Hori,
  • Hirofumi Abe,
  • Shinwa Tanaka,
  • Hiroya Sakaguchi,
  • Kazunori Tsuda,
  • Chise Ueda,
  • Fumiaki Kawara,
  • Takashi Toyonaga,
  • Masato Kinoshita,
  • Satoshi Urakami,
  • Tatsuya Nakai,
  • Shinya Hoki,
  • Hiroshi Tanabe,
  • Yuzo Kodama

摘要

Background

Patients with esophageal motility disorders (EMDs) sometimes develop bacterial pneumonia (BP). However, factors associated with BP in patients with EMDs and whether peroral endoscopic myotomy (POEM) reduces BP development are unclear. Therefore, this study aimed to identify factors associated with BP development and evaluate the preventive potential of POEM in patients with EMDs.

Methods

This study included 623 patients diagnosed with EMDs at our institution between April 2015 and March 2023. Factors associated with BP were analyzed by comparing characteristics between patients who developed BP within 1 year before diagnosis using multivariable analysis. The potential of POEM to prevent BP development was assessed using Cox regression analysis, considering treatment status as a time-varying covariate.

Results

Of the 623 patients, 31 (5.0%) developed BP within 1 year before diagnosis. Older age (odds ratio [OR] = 1.29, 95% confidence interval [CI] 1.04–1.59, p = 0.019; 10-year increments), lower body mass index (OR = 0.87, 95% CI 0.78–0.98, p = 0.026), and manometric diagnosis of spastic esophageal disorders (OR = 2.97, 95% CI 1.24–7.16, p = 0.015) were significantly associated with BP. Treatment status of POEM was proved to be a significant factor for developing BP using Cox regression analysis (hazard ratio = 0.17, 95% CI 0.039–0.75, p = 0.019).

Conclusions

Risk factors associated with BP in patients with EMDs were older age, lower body mass index, and manometric diagnosis of spastic esophageal disorders. POEM could decrease spasm-related bolus reflux, improve patients’ nutritional status through resolution of transit disturbance, and reduce respiratory complications, suggesting that POEM could help prevent BP development.