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Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis

BACKGROUND: Gastroparesis is a debilitating condition that may impact morbidity and mortality, but there is a lack of long-term studies examining this relation. The aim of this study was to determine the predictors of mortality in gastroparesis and to determine the nutritional deficiencies. METHODS:...

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Autores principales: Amjad, Waseem, Qureshi, Waqas, Singh, Ritu R., Richter, Seth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hellenic Society of Gastroenterology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596206/
https://www.ncbi.nlm.nih.gov/pubmed/34815644
http://dx.doi.org/10.20524/aog.2021.0660
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author Amjad, Waseem
Qureshi, Waqas
Singh, Ritu R.
Richter, Seth
author_facet Amjad, Waseem
Qureshi, Waqas
Singh, Ritu R.
Richter, Seth
author_sort Amjad, Waseem
collection PubMed
description BACKGROUND: Gastroparesis is a debilitating condition that may impact morbidity and mortality, but there is a lack of long-term studies examining this relation. The aim of this study was to determine the predictors of mortality in gastroparesis and to determine the nutritional deficiencies. METHODS: Between September 30, 2009 and January 31, 2020, we identified 320 patients (mean age 47.5±5.3 years, 70% female, 71.3% Whites, 39.7% diabetic and 60.3% nondiabetic) with gastroparesis. (99m)Tc sulfur-labeled food was used to diagnose gastroparesis. Cox proportional-hazard regression was used to compute the association of mortality predictors. RESULTS: Of the 320 patients, 46 (14.4%) died during the study period. Among diabetics, advanced age (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.03-1.10; P<0.001), chronic kidney disease (CKD) (HR 4.69, 95%CI 1.62-13.59; P=0.004), and malnutrition (HR 10.95, 95%CI 3.23-37.17; P<0.001) were associated with higher mortality, whereas in nondiabetics older age (HR 1.05, 95%CI 1.01-1.09; P=0.04), CKD (HR 10.2, 95%CI 2.48-41.99; P=0.001), chronic obstructive pulmonary disease (COPD) (HR 7.5, 95%CI 2.11-26.82; P=0.002), coronary artery disease (CAD) (HR 9.7, 95%CI 1.8-52.21; P=0.008), and malnutrition (HR 3.83, 95%CI 1.14-29.07; P=0.03) were associated with increased mortality. Overall, 48.8% had vitamin D, 18.2% had vitamin B12, and 50.8% had iron deficiencies. Only 19.4% of the whole cohort was evaluated by a nutritionist. CONCLUSIONS: Advanced age, CAD, CKD, COPD and malnutrition were associated with higher mortality in gastroparesis. Despite the high prevalence of nutritional deficiencies, consultation of a specialist nutritionist was uncommon.
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spelling pubmed-85962062021-11-22 Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis Amjad, Waseem Qureshi, Waqas Singh, Ritu R. Richter, Seth Ann Gastroenterol Original Article BACKGROUND: Gastroparesis is a debilitating condition that may impact morbidity and mortality, but there is a lack of long-term studies examining this relation. The aim of this study was to determine the predictors of mortality in gastroparesis and to determine the nutritional deficiencies. METHODS: Between September 30, 2009 and January 31, 2020, we identified 320 patients (mean age 47.5±5.3 years, 70% female, 71.3% Whites, 39.7% diabetic and 60.3% nondiabetic) with gastroparesis. (99m)Tc sulfur-labeled food was used to diagnose gastroparesis. Cox proportional-hazard regression was used to compute the association of mortality predictors. RESULTS: Of the 320 patients, 46 (14.4%) died during the study period. Among diabetics, advanced age (hazard ratio [HR] 1.06, 95% confidence interval [CI] 1.03-1.10; P<0.001), chronic kidney disease (CKD) (HR 4.69, 95%CI 1.62-13.59; P=0.004), and malnutrition (HR 10.95, 95%CI 3.23-37.17; P<0.001) were associated with higher mortality, whereas in nondiabetics older age (HR 1.05, 95%CI 1.01-1.09; P=0.04), CKD (HR 10.2, 95%CI 2.48-41.99; P=0.001), chronic obstructive pulmonary disease (COPD) (HR 7.5, 95%CI 2.11-26.82; P=0.002), coronary artery disease (CAD) (HR 9.7, 95%CI 1.8-52.21; P=0.008), and malnutrition (HR 3.83, 95%CI 1.14-29.07; P=0.03) were associated with increased mortality. Overall, 48.8% had vitamin D, 18.2% had vitamin B12, and 50.8% had iron deficiencies. Only 19.4% of the whole cohort was evaluated by a nutritionist. CONCLUSIONS: Advanced age, CAD, CKD, COPD and malnutrition were associated with higher mortality in gastroparesis. Despite the high prevalence of nutritional deficiencies, consultation of a specialist nutritionist was uncommon. Hellenic Society of Gastroenterology 2021 2021-09-14 /pmc/articles/PMC8596206/ /pubmed/34815644 http://dx.doi.org/10.20524/aog.2021.0660 Text en Copyright: © Hellenic Society of Gastroenterology https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Amjad, Waseem
Qureshi, Waqas
Singh, Ritu R.
Richter, Seth
Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title_full Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title_fullStr Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title_full_unstemmed Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title_short Nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
title_sort nutritional deficiencies and predictors of mortality in diabetic and nondiabetic gastroparesis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8596206/
https://www.ncbi.nlm.nih.gov/pubmed/34815644
http://dx.doi.org/10.20524/aog.2021.0660
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