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Abstract:
BACKGROUND & AIMS:Anesthesia services for endoscopic procedures have proliferated with the promise of increased comfort and safety. Cirrhosis patients are higher risk for sedation, yet limited data are available describing anesthesia complications in this population. APPROACH & RESULTS:This cross-sectional study utilized the National Anesthesia Clinical Outcomes Registry, a multi-center quality improvement database from 2010 to 2015. Cirrhosis patients undergoing an endoscopy were identified by ICD 9/CPT codes. The outcome of interest was serious anesthesia-related complication defined as cardiovascular, respiratory, neurologic, drug-related, patient injury, death, or unexpected admission. A mixed effects multivariate logistic regression model determined odds ratios between variables and serious complications adjusting for potential confounders. In total, 9,007 endoscopic procedures were performed among cirrhosis patients; 92% were esophagogastroduodenoscopies. A majority (81%) were American Society of Anesthesiologists (ASA) class >=3 and 72% had a history of hepatic encephalopathy, ascites, varices, hepatorenal syndrome, or spontaneous bacterial peritonitis identified by ICD-9/CPT codes. In total, 87 complications were reported, 33 of which were serious. The frequency of serious complications was 0.4% or 378.6 per 100,000 procedures (95% CI 260.8, 531.3). A majority of serious complications were cardiovascular (21/33) including 15 cardiac arrests. Serious complications were significantly associated with ASA4/5 (OR 3.84; 95% CI 1.09, 13.57) and general anesthesia (OR 4.71; 95% CI 1.20, 18.50) adjusting for age, sex, ASA class, anesthesia type, inpatient status, portal hypertension history, and variable complication reporting practices. CONCLUSIONS:Anesthesia complications among endoscopic procedures in cirrhosis are rare overall. Serious complications were predominantly cardiac and associated with sicker patients undergoing general anesthesia. The complexity of end stage liver disease may warrant more intensive care during endoscopic procedures including anesthesia monitoring.
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最新影响因子:17.298 | 期刊ISSN:0270-9139 | CiteScore:6.91 |
出版周期:Monthly | 是否OA:YES | 出版年份:1981 |
期刊官方网址:http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)1527-3350/
自引率:4.50% | 研究方向:医学-胃肠肝病学 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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The premier publication in the field of liver disease, Hepatology publishes original, peer-reviewed articles concerning all aspects of liver structure, function and disease. Each month, the distinguished Editorial Board monitors and selects only the best articles on subjects such as immunology, chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, and drug metabolism.
肝病学是肝病领域的主要出版物,它发表关于肝脏结构、功能和疾病的所有方面的原创的、经过同行评审的文章。每个月,杰出的编辑委员会只对免疫学、慢性肝炎、病毒性肝炎、肝硬化、遗传性和代谢性肝病及其并发症、肝癌和药物代谢等方面的最佳文章进行监测和选择。
大类(学科) | 小类(学科) | 学科排名 |
医学 |
GASTROENTEROLOGY & HEPATOLOGY (胃肠肝病学) 2区 |
5/80 |
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
290 | 267 | 23 |
引文计数(2018)
文献(2015-2017)
12820次引用
1855篇文献
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Hepatology
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#3/59
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审稿时间: 3个月内 接受率: 非常困难(几乎不命中)
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审稿时间: 2个月内 接受率: 比较困难(25%命中)
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研究方向:肝病
审稿时间: 2个月内 接受率: 比较困难(25%命中)
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