认知障碍是否与肠道对结肠镜检查的准备不足有关?
Jeanette M Daly1, Yinghui Xu2, Seth D Crockett2
1From the University of Iowa Carver College of Medicine, Iowa City, IA (JMD, YX, RMH, BTL); University of North Carolina School of Medicine, Chapel Hill, NC (SDC); Oregon Health & Science University and Portland VA Medical Center, Portland, OR (SDC); Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA (RMH, BTL); and University of Iowa College of Public Health, Iowa City, IA (BTL). jeanette-daly@uiowa.edu).
较低的家庭收入,而不是认知状态,显著增加了肠道不充分准备结肠镜的风险. 这一发现对于改善结肠镜成功率和患者的治疗结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
- 认知科学 认知科学
背景情况:
- 不充分的肠道准备 (IBP) 会对结肠镜疗效产生负面影响,导致错误诊断和增加医疗保健成本.
- 影响IBP的因素对于开发有针对性的干预措施来提高结肠镜质量至关重要.
- 通过像时钟绘图测试这样的工具来评估认知状态,是IBP的一个潜在的,但尚未研究的因素.
研究的目的:
- 要确定通过异常时钟绘图测试表明的认知状态受损是否与肠道准备不足 (IBP) 有关.
- 在接受结肠镜检查的患者中确定与IBP相关的人口和临床特征.
主要方法:
- 一项横截面队列研究,涉及2016名年龄在50-85岁的参与者,接受查或监测结肠镜检查.
- 在结肠镜检查之前,参与者完成了便测试和时钟绘图测试.
- 使用阿伦奇克肠道准备分数评估IBP;通过验证的时钟绘图方法评估认知状态.
主要成果:
- 在2,016名参与者中,6% (119) 患有IBP,21% (421) 显示出异常的时钟图.
- 在对年龄进行控制后,一个异常的时钟绘图得分没有显示出与IBP的统计学上显著的关联 (OR=1.44,95%CI:0.94-2.22).
- 较低的家庭收入 (<40,000美元) 与较高收入 (>80,000美元) 相比,与IBP (OR=2.48,95% CI:1.56-3.95) 的几率增加显著相关.
结论:
- 较低的家庭收入是肠道对结肠镜检查准备不足的重要预测因素.
- 通过时钟绘图测试测量的认知障碍在这个队列中没有发现与IBP有显著的关联.
- 研究结果表明,社会经济因素在IBP中扮演着比认知状态更重要的角色,指导未来的干预策略.
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