A232 PEG-J RELATED COMPLICATIONS IN A CANADIAN OUTPATIENT INTRAJEJUNAL LEVODOPA/CARBIDOPA PROGRAM FOR ADVANCED PARKINSON’S DISEASE
Notice bibliographique
Résumé
Levodopa/carbidopa intestinal gel (LCIG) has been found to significantly improve motor fluctuation in patients with advanced Parkinson’s disease (PD) by reducing “off” time and increasing “on” time without troublesome dyskinesia. LCIG is delivered continuously via an intrajejunal tube through a percutaneous entroscopic gastrotomy (PEG-J). Adverse events of LCIG treatment program have been largely attributed to the PEG-J procedure and the device, rather than the LCIG medication itself. To date, data evaluating long-term efficacy and safety are limited. This study is a quality improvement self-audit of our outpatient LCIG program at a tertiary center in Toronto, Ontario. Through this audit, we aim to describe the current outpatient PEG-J and LCIG treatment program (Figure 1), document short and long-term adverse events (AEs), hospitalization rates and frequency of PEG-J removal and/or exchange. These data will be compared with previously published inpatient treatment programs. All PD patients who underwent PEG-J insertion for LCIG therapy at Toronto Western Hospital, University Health Network between January 2015 and March 2018 were identified prospectively. Only patients who underwent PEG-J insertion for LCIG initiation as an outpatient were included. Variables of patient demographics, PD factors and PEG-J factors were collected using a standardized data collection sheet. Data were analyzed using standard descriptive statistical methods. A total of 45 patients were identified and included in the final analysis. Mean age at study recruitment was 72 years (standard deviation, SD=7 years), with a mean duration of PD of 15 years (SD=7 years). 60% of patients were male, and 40% were female. Mean time from PEG-J insertion and study inclusion was 21.95 months (SD=13.74 months). Patient medications at time of PEG-J insertion were summarized. Post-procedure complications were documented. There were no reported serious adverse events (SAEs), including post-procedure perforations, bleeds, fistulas, intra-abdominal collections or buried bumper syndrome. The study population of our outpatient PEG-J LCIG treatment program was comparable to that described in previous studies. The main relevant finding was the absence of serious adverse events. The largest cohort to date included 395 patients, with a SAE rate of 17% (68/395). We believe that the minimum 2-week delay between PEG-J insertion and initiation of LCIG to allow maturation of the fistulous tract may potentially lead to a reduction in PEG-J related complications. In conclusion, LCIG has been proven to be a promising treatment option for patients with advanced PD. This study supports that the current model the outpatient PEG-J LCIG treatment program is safe and effective. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| 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 | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 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 source (Gemma direct ou Codex distillé), 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 ».