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| 1 | Gastric food retention at endoscopy is associated with severity of liver cirrhosis显示文摘BACKGROUND Gastrointestinal symptoms are prevalent in patients with cirrhosis.Cirrhotic patients have a known predilection to delayed gastric emptying compared to those without cirrhosis.However,the contributing factors have not been fully elucidated.Retained gastric food on esophagogastroduodenoscopy(EGD)has been used as a surrogate marker for delayed gastric emptying with reasonably high specificity.Therefore,we hypothesize that the frequency of retained gastric food contents at EGD will be higher in a cirrhotic population compared to a control population without liver disease.Additionally,we hypothesize that increased frequency of gastric food contents will be associated with increased severity of cirrhosis.AIM To determine the relative frequency of delayed gastric emptying among cirrhotics as compared to non-cirrhotics and to identify associated factors.METHODSWe performed a retrospective case-control study of cirrhotic subjects whounderwent EGD at an academic medical center between 2000 and 2015. Threehundred sixty-four patients with confirmed cirrhosis, who underwent a total of1044 EGDs for the indication of esophageal variceal screening or surveillance,were identified. During the same period, 519 control patients without liverdisease, who underwent a total of 881 EGDs for the indication of anemia, wereidentified. The presence of retained food on EGD was used as a surrogate fordelayed gastric emptying. The relative frequency of delayed gastric emptyingamong cirrhotics was compared to non-cirrhotics. Characteristics of patients withand without retained food on EGD were compared using univariable andmultivariable logistic regression analysis to identify associated factors.RESULTSOverall, 40 (4.5%) patients had evidence of retained food on EGD. Cirrhotics weremore likely to have retained food on EGD than non-cirrhotics (9.1% vs 1.4%, P <0.001). Characteristics associated with retained food on univariable analysisincluded age less than 60 years (12.6% vs 5.2%, P = 0.015), opioid use (P = 0.004),Child-Pugh class C (24.1% Child-Pugh class C vs 6.4% Child-Pugh class A, P =0.007), and lower platelet count (P = 0.027). On multivariate logistic regressionanalysis, in addition to the presence of cirrhosis (adjusted OR = 5.83;95%CI: 2.32-14.7, P < 0.001), diabetes mellitus (types 1 and 2 combined) (OR = 2.34;95%CI:1.08-5.06, P = 0.031), opioid use (OR = 3.08;95%CI: 1.29-7.34, P = 0.011), andChild-Pugh class C (OR = 4.29;95%CI: 1.43-12.9, P = 0.01) were also associatedwith a higher likelihood of food retention on EGD.CONCLUSIONCirrhotics have a higher frequency of retained food at EGD than non-cirrhotics.Decompensated cirrhosis, defined by Child-Pugh class C, is associated with ahigher likelihood of delayed gastric emptying. | David B Snell Shirley Cohen-Mekelburg Russell Weg Gaurav Ghosh Adam P Buckholz Amit Mehta Xiaoyue Ma Paul J Christos Arun B Jesudian | 2019 | World Journal of Hepatology2019，11，11： | 2 |
| 2 | Human resource management, manufacturing strategy, and firm performance 显示文摘 | Youndt M A Snell S A Dean J W Lepak D P | 1996 | Academy of Management Journal1996，39，： | 1 |
| 3 | Shutter image converter tubes显示文摘 | Linden B R Snell P A | 1957 | Proc IRE1957，45，3： | 1 |
| 4 | The effect of running on serum and red cell ferritin: Alongitudinal comparison显示文摘 | Balaban EP Snell P Stray GJ | 1995 | Int Sports Med1995，16，5： | 1 |
| 5 | Validation of use of whole-cell repetitive extragenic palindromic sequence-based PCR (REP-PCR) for typing strains belonging to the Acinetobacter cal- coaeeticus-Acinetobaeter baumannii complex and application of the method to the investigation of a hospital outbreak显示文摘 | Snelling AM Gerner-Smidt P Hawkey PM | 1996 | J Clin Microbi- ol1996，34，5： | 1 |
| 6 | An investigatordriven study of everolimus in surgical lung biopsy confirmed idiopathic pulmonary fibrosis显示文摘 | Malouf MA Hopkins P Snell G | 2011 | Respirology2011，16，3： | 1 |
| 7 | Microdissection RT-PCR analysis of gene expression in pathologically defined frozen tissues 显示文摘 | Snell L Watson P | 1996 | Biotechniques1996，21，1： | 1 |
| 8 | Task Force 8:classification of sports显示文摘 | Mitchell JH Haskell W Snell P | 2005 | J Am Coil Cardiol2005，45，8： | 1 |
| 9 | Human resource and the resource based view of the firm 显示文摘 | Wright P M Dunford B B Snell S A | 2001 | Journal of Management Journal2001，，27： | 1 |
| 10 | Employment Flexibility and Firm Performances:Examining the Interaction Effects of Employment Mode,Environmental Dynamism,and Technological Intensity显示文摘 | Lepak D P Takeuchi R Snell S A | 2003 | Journal of Management2003，29，3： | 1 |
| 11 | Information flows: the real art of infor- mation management and freedom of information 显示文摘 | SNELL R SEBINA P | 2007 | Archives and Manuscripts2007，，35： | 1 |
| 12 | Thickness Variation of the Magneto-optical Properties of Tb,Dy-Fe Co Pr Thin Films显示文摘 | Carey R Newman D M Snelling J P | 1995 | Thin Soild Film1995，259，： | 1 |
| 13 | Comparing line and HR executives perceptions of HR effectiveness: services, roles, and contributions显示文摘 | WRIGHT P MCMAHAN G SNELL S GERHART B | 2001 | Hu- man Resource Management Journal2001，，40： | 1 |
| 14 | Maximal oxy- gen uptake as a parametric measure of cardiorespiratory ca- pacity显示文摘 | Hawkins M N Raven P B Snell P G | 2007 | Med Sci Sports Exerc2007，39，1： | 1 |
| 15 | Examining the human resource archi- tecture: The relationships among human capital, employment, and human resource configurations 显示文摘 | LEPAK D P SNELL S A | 2002 | Journal of Management2002，28，4： | 1 |
| 16 | Everolimus versus azathioprine in maintenance lung transplant recipients : an international, randomized, double-blind clinical trial显示文摘 | Snell GI Valentine VG Vitulo P | 2006 | Am J Transplant2006，6，1： | 1 |
| 17 | The Human Resource Architecture:Toward A Theory Of Human Capital Allocation And Development显示文摘 | LEPAK D P SNELL S A | 1999 | Academy of Management Reiew1999，24，1： | 1 |
| 18 | The human resource architec- ture:toward a theory o{ human capital allocation and devel- opment显示文摘 | LEPAK D P SNELL S A | 1999 | Academy of Management Review1999，24，1： | 1 |
| 19 | A feasibility and safety study of bronchoscopic thermal vapor ablation; a novel emphysema therapy显示文摘 | Snell GIfHopkins P Westall G | 2009 | Ann Thorac Surg2009，88，6： | 1 |
| 20 | Bronchoscopic thermal vapour ablation therapy in the management of heterogeneous emphysema显示文摘 | Snell G Herth FJ Hopkins P | 2012 | Eur Respir J2012，39，13： | 1 |
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