Manometric and demographic predictors of incomplete bolus transit in patients diagnosed with ineffective esophageal motility
Notice bibliographique
Résumé
Ineffective esophageal motility (IEM), or frequent failed peristalsis in the Chicago Classification, is a common motility abnormality describing a non-specific manometric pattern of peristaltic failure. With the addition of multichannel intraluminal impedance technology to high resolution esophageal manometry (HRM), evaluation of bolus transit simultaneously with esophageal contraction is possible. However, manometric predictors of incomplete bolus transit (IBT) in the setting of IEM have not been fully characterized. REB-approved retrospective chart review of patients diagnosed with IEM at a regional gut motility centre. All subjects were clinically assessed prior to HRM with a detailed history containing the patient's primary complaints, other pertinent symptoms and demographic information. HRM with impedance studies (Given Imaging, Inc) were performed by standard protocol. Summary (averaged) data from each patient was compared. To examine which manometric variables best predicted the percentage of swallows with incomplete bolus transit for any given patient, a multiple linear regression was performed using selected variables, and adjusted for age and gender (SPSS 21). All tests were two-sided and significance was set at the 95% level. 230 patients (130 female; mean age 52 yr; range 18-82 yr) with a manometric diagnosis of IEM were included. The primary complaints of patients included dysphagia (33.9%), heartburn/reflux (33.0%), chest pain (11.7%), other (10.9%), and cough (8.7%). Many patients had more than one symptom; however there were no significant differences in baseline characteristics across primary symptom groups (data not shown). The multiple regression model fit was highly significant (F=10.14, 9 df, p<0.001) with an adjusted r square of 0.373. In the model, decreasing proportions of peristaltic contractions correlated significantly with decreased bolus transit (ie higher percentage of incomplete bolus transit). Similarly, higher intrabolus pressure correlated significantly with higher percentages of incomplete bolus transit. The remainder of the manometric variables were not significantly associated with IBT. Gender was not significant but increasing age was associated with less IBT. As expected, peristaltic contractions predict adequate bolus transit in aggregate data, while increased intrabolus pressure predicted incomplete bolus transit. Further questions being evaluated in this study sample include effects of medications and connective tissue disorders on HRM and bolus transit variables in the setting of IEM.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».