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| 1 | Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms显示文摘AIM:To investigate the risk factors for delayed bleeding following endoscopic submucosal dissection(ESD)treatment for colorectal neoplasms.METHODS:We retrospectively reviewed the medical records of 317 consecutive patients with 325 lesions who underwent ESD for superficial colorectal neoplasms at our hospital from January 2009 to June2013.Delayed post-ESD bleeding was defined as bleeding that resulted in overt hematochezia 6 h to 30d after ESD and the observation of bleeding spots as confirmed by repeat colonoscopy or a required blood transfusion.We analyzed the relationship between risk factors for delayed bleeding following ESD and the following factors using univariate and multivariate analyses:age,gender,presence of comorbidities,use of antithrombotic drugs,use of intravenous heparin,resected specimen size,lesion size,lesion location,lesion morphology,lesion histology,the device used,procedure time,and the presence of significant bleeding during ESD.RESULTS:Delayed post-ESD bleeding was found in14 lesions from 14 patients(4.3%of all specimens,4.4%patients).Patients with episodes of delayed postESD bleeding had a mean hemoglobin decrease of2.35 g/dL.All episodes were treated successfully using endoscopic hemostatic clips.Emergency surgery was not required in any of the cases.Blood transfusion was needed in 1 patient(0.3%).Univariate analysis revealed that lesions located in the cecum(P=0.012)and the presence of significant bleeding during ESD(P=0.024)were significantly associated with delayed post-ESD bleeding.The risk of delayed bleeding was higher for larger lesion sizes,but this trend was not statistically significant.Multivariate analysis revealed that lesions located in the cecum(OR=7.26,95%CI:1.99-26.55,P=0.003)and the presence of significant bleeding during ESD(OR=16.41,95%CI:2.60-103.68,P=0.003)were independent risk factors for delayed post-ESD bleeding.CONCLUSION:Location in the cecum and significant bleeding during ESD predispose patients to delayed post-procedural bleeding.Therefore,careful and additional management is recommended for these patients. | Sho Suzuki Akiko Chino Teruhito Kishihara Naoyuki Uragami Yoshiro Tamegai Takanori Suganuma Junko Fujisaki Masaaki Matsuura Takao Itoi Takuji Gotoda Masahiro Igarashi Fuminori Moriyasu | 2014 | World Journal of Gastroenterology2014，20，7： | 21 |
| 2 | Development of Helicobacter pylori treatment: How do we manage antimicrobial resistance?显示文摘Helicobacter pylori(H. pylori) antimicrobial resistance is an urgent, global issue. In2017, the World Health Organization designated clarithromycin-resistant H.pylori as a high priority bacterium for antibiotic research and development. In addition to clarithromycin, resistance to metronidazole and fluoroquinolones has also increased worldwide. Recent international guidelines for management of H.pylori infection recommend bismuth or non-bismuth quadruple therapy for 14 d as a first-line treatment for H. pylori in areas of high clarithromycin and/or metronidazole resistance. Although these treatment regimens provide acceptable H. pylori eradication rates, the regimens used should not contribute to future resistance of H. pylori to antimicrobials. Moreover, these regimens can promote resistance, due to prolonged therapy with multiple antibiotics. A new strategy that can eradicate H. pylori as well as reduce the antibiotics used is required to prevent future antimicrobial resistance in H. pylori. Dual-therapy with vonoprazan and amoxicillin could be a breakthrough for H. pylori eradication in an era of growing antimicrobial resistance. This regimen may provide a satisfactory eradication rate of H. pylori and also minimize antimicrobial resistance due to single antibiotic use and the strong inhibitory effect of vonoprazan on gastric acid secretion. | Sho Suzuki Mitsuru Esaki Chika Kusano Hisatomo Ikehara Takuji Gotoda | 2019 | World Journal of Gastroenterology2019，25，16： | 17 |
| 3 | Endoscopic diagnosis and treatment of superficial nonampullary duodenal tumors显示文摘The diagnostic and treatment guidelines of superficial non-ampullary duodenal tumors have not been standardized due to their low prevalence.Previous reports suggested that a superficial adenocarcinoma(SAC) should be treated via local resection because of its low risk of lymph node metastasis,whereas a highgrade adenoma(HGA) should be resected because of its high risk of progression to adenocarcinoma.Therefore,pretreatment diagnosis of SAC or HGA is important to determine the appropriate treatment strategy.There are certain endoscopic features known to be associated with SAC or HGA,and current practice prioritizes the endoscopic and biopsy diagnosis of these conditions.Surgical treatment of these duodenal lesions is often related to high risk of morbidity,and therefore endoscopic resection has become increasingly common in recent years.Endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) are the commonly performed endoscopic resection methods.EMR is preferred due to its lower risk of adverse events;however,it has a higher risk of recurrence than ESD.Recently,a new and safer endoscopic procedure that reduces adverse events from EMR or ESD has been reported. | Mitsuru Esaki Sho Suzuki Hisatomo Ikehara Chika Kusano Takuji Gotoda | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，9： | 7 |
| 4 | Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis显示文摘AIM: To clarify the effectiveness and safety of endo- scopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC). METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events. RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P=0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P=0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%). CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC. | Masato Matsuyama Hiroshi Ishii Kensuke Kuraoka Seigo Yukisawa Akiyoshi Kasuga Masato Ozaka Sho Suzuki Kouichi Takano Yuko Sugiyama Takao Itoi | 2013 | World Journal of Gastroenterology2013，19，15： | 5 |
| 5 | Clinical impact of endoscopy position detecting unit(UPD-3) for a non-sedated colonoscopy显示文摘AIM:To evaluate whether an endoscopy position detecting unit(UPD-3) can improve cecal intubation rates, cecal intubation times and visual analog scale(VAS) pain scores, regardless of the colonoscopist's level of experience.METHODS:A total of 260 patients(170 men and 90women)who underwent a colonoscopy were divided into the UPD-3-guided group or the conventional group(no UPD-3 guidance).Colonoscopies were performed by experts(experience of more than 1000colonoscopies)or trainees(experience of less than 100colonoscopies).Cecal intubation rates,cecal intubation times,insertion methods(straight insertion:shortening the colonic fold through the bending technique;roping insertion:right turn shortening technique)and patient discomfort were assessed.Patient discomfort during the endoscope insertion was scored by the VAS that was divided into 6 degrees of pain.RESULTS:The cecum intubation rates,cecal intubation times,number of cecal intubations that were performed in<15 min and insertion methods were not significantly different between the conventional group and the UPD-3-guided group.The number of patients who experienced pain during the insertion was markedly less in the UPD-3-guided group than in the conventional group.Univariate and multivariate analysis showed that the following factors were associated with lower VAS pain scores during endoscope insertion:insertion method(straight insertion)and UPD-3guidance in the trainee group.For the experts group,univariate analysis showed that only the insertion method(straight insertion)was associated with lower VAS pain scores.CONCLUSION:Although UPD-3 guidance did not shorten intubation times,it resulted in less patient painduring endoscope insertion compared with conventional endoscopy for the procedures performed by trainees. | Masakatsu Fukuzawa Junichi Uematsu Shin Kono Sho Suzuki Takemasa Sato Naoko Yagi Yuichiro Tsuji Kenji Yagi Chika Kusano Takuji Gotoda Takashi Kawai Fuminori Moriyasu | 2015 | World Journal of Gastroenterology2015，21，16： | 5 |
| 6 | Endoscopic resection for residual lesion of metastatic gastric cancer:A case report显示文摘BACKGROUND Chemotherapy is a standard strategy for stage IV gastric cancer patients.However, some cases cannot undergo conversion surgery because of their frailty,even if the patients had response to chemotherapy. For these patients, local tumor progression is a problem. We report here the case of a patient whose residual gastric cancer was resected through endoscopic submucosal dissection(ESD)after concomitant chemotherapy for metastatic gastric cancer.CASE SUMMARY An 85-year-old male complained of difficulty swallowing, and examination revealed gastric cancer with multiple liver metastases. Although he received concomitant chemotherapy, a residual tumor was observed in the primary lesion while the metastatic lesions disappeared completely. Conversion surgery was considered optional treatment; however, he could not undergo that because of advanced age and comorbidities. Thus, we performed ESD to treat the residual tumor. As a result, we resected the residual lesion completely. The patient has been alive for 29 mo since ESD, without recurrence.CONCLUSION We achieved local control using ESD, and these findings may provide therapeutic improvements both in local control and patient survival outcomes. | Kaori Hayashi Sho Suzuki Hisatomo Ikehara Hiroaki Okuno Akira Irie Mitsuru Esaki Chika Kusano Takuji Gotoda Mitsuhiko Moriyama | 2019 | World Journal of Clinical Cases2019，7，4： | 2 |
| 7 | Endoscopic mucosal resection vs endoscopic submucosal dissection for superficial non-ampullary duodenal tumors显示文摘BACKGROUND The selection of endoscopic treatments for superficial non-ampullary duodenal epithelial tumors(SNADETs)is controversial.AIM To compare the efficacy and safety of endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)for SNADETs.METHODS We retrospectively analyzed the data of patients with SNADETs from a database of endoscopic treatment for SNADETs,which included eight hospitals in Fukuoka,Japan,between April 2001 and October 2017.A total of 142 patients with SNADETs treated with EMR or ESD were analyzed.Propensity score matching was performed to adjust for the differences in the patient characteristics between the two groups.We analyzed the treatment outcomes,including the rates of en bloc/complete resection,procedure time,adverse event rate,hospital stay,and local or metastatic recurrence.RESULTS Twenty-eight pairs of patients were created.The characteristics of patients between the two groups were similar after matching.The EMR group had a significantly shorter procedure time and hospital stay than those of the ESD group[median procedure time(interquartile range):6(3-10.75)min vs 87.5(68.5-136.5)min,P<0.001,hospital stay:8(6-10.75)d vs 11(8.25-14.75)d,P=0.006].Other outcomes were not significantly different between the two groups(en bloc resection rate:82.1%vs 92.9%,P=0.42;complete resection rate:71.4%vs 89.3%,P=0.18;and adverse event rate:3.6%vs 17.9%,P=0.19,local recurrence rate:3.6%vs 0%,P=1;metastatic recurrence rate:0%in both).Only one patient in the ESD group underwent emergency surgery owing to intraoperative perforation.CONCLUSION EMR has significantly shorter procedure time and hospital stay than ESD,and provides acceptable curability and safety compared to ESD.Accordingly,EMR for SNADETs is associated with lower medical costs. | Mitsuru Esaki Kazuhiro Haraguchi Kazuya Akahoshi Naru Tomoeda Akira Aso Soichi Itaba Haruei Ogino Yusuke Kitagawa Hiroyuki Fujii Kazuhiko Nakamura Masaru Kubokawa Naohiko Harada Yosuke Minoda Sho Suzuki Eikichi Ihara Yoshihiro Ogawa | 2020 | World Journal of Gastrointestinal Oncology2020，12，8： | 2 |
| 8 | Develop- ment of cam-drive type proportional valve for water hy- draulics显示文摘 | Kenji Suzuki Sho Akazawa Yohichi Nakao | 2012 | Int J Automat Technol2012，6，4： | 1 |
| 9 | Effectiveness and safety of sedation in gastrointestinal endoscopy:An opinion review显示文摘Although endoscopy is a less invasive procedure than surgery,patients can experience pain without sedation.Patients expect reduced pain during endoscopies from effective and safe sedatives.Midazolam and propofol are used for endoscopic sedation in many countries and regions.Midazolam is a widely available benzodiazepine,and many clinical trials have shown it to be an effective sedative.However,patients who are sedated with midazolam require rest in the recovery room due to its relatively long half-life,and an antagonist such as flumazenil may need to be administered in cases of deep or prolonged sedation.Propofol is a short-acting sedative with a short half-life and a quick recovery time.Therefore,the use of propofol has been increasing.However,propofol has a narrow margin of safety and often induces adverse effects such as respiratory depression.Also,propofol has no specific antagonist,and should be administered by an anesthesiologist or an endoscopist familiar with anesthesia.Remimazolam,which is a novel ultra-short-acting benzodiazepine,has recently gained attention.Remimazolam has a short half-life and an antagonist.Both effective and safe sedation is desired in accordance with the increasing need for sedative endoscopies.Therefore,in this review each sedative is summarized. | Ryoji Ichijima Mitsuru Esaki Sho Suzuki Chika Kusano Hisatomo Ikehara Takuji Gotoda | 2020 | World Journal of Meta-Analysis2020，8，2： | 1 |
| 10 | Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms显示文摘AIM To compare the outcomes of endoscopic submucosal dissection(ESD) for gastric neoplasms using Clutch Cutter(ESD-C) or other knives(ESD-O).METHODS This was a single-center retrospective study. Gastric neoplasms treated by ESD between April 2016 and October 2017 at Kitakyushu Municipal Medical Center were reviewed. Multivariate analyses and propensity score matching were used to reduce biases. Covariates included factors that might affect outcomes of ESD, including age, sex, underlying disease, anti-thrombotic drugs use, tumor location, tumor position, tumor size, tumor depth, tumor morphology, tumor histology, ulcer(scar), and operator skill. The treatment outcomes were compared among two groups. The primary outcome was ESD procedure time. Secondary outcomes were en bloc, complete, and curative resection rates, and adverse events rates including perforation and delayed bleeding.RESULTS A total of 155 patients were included in this study; 44 pairs were created by propensity score matching. Background characteristics were quite similar among two groups after matching. Procedure time was significantly shorter for ESD-C(median; 49 min) than for ESD-O(median; 88.5 min)(P < 0.01). However, there was no significant difference in treatment outcomes between ESD-C and ESD-O including en bloc resection rate(100% in both groups), complete resection rate(100% in both groups), curative resection rate(86.4% vs 88.6%, P = 0.730), delayed bleeding(2.3% vs 6.8%, P = 0.62) and perforation(0% in both groups).CONCLUSION ESD-C achieved shorter procedure time without an increase in complication risk. Therefore, ESD-C could become an effective ESD option for gastric neoplasms. | Yasuyo Hayashi Mitsuru Esaki Sho Suzuki Eikichi Ihara Azusa Yokoyama Seiichiro Sakisaka Taizo Hosokawa Yoshimasa Tanaka Takahiro Mizutani Shinichi Tsuruta Aya Iwao Shun Yamakawa Akira Irie Yosuke Minoda Yoshitaka Hata Haruei Ogino Hirotada Akiho Yoshihiro Ogawa | 2018 | World Journal of Gastrointestinal Oncology2018，10，12： | 1 |
| 11 | Usefulness of a traction method using dental floss and a hemoclip for gastric endoscopic submucosal dissection: a propensity score matching analysis (with videos)显示文摘 | Sho Suzuki Takuji Gotoda Yoshiyuki Kobayashi Shin Kono Kunio Iwatsuka Naoko Yagi-Kuwata Chika Kusano Masakatsu Fukuzawa Fuminori Moriyasu | 2015 | Gastrointestinal Endoscopy2015，，： | 1 |
| 12 | Assistant skill in gastric endoscopic submucosal dissection using a clutch cutter显示文摘BACKGROUND A clutch cutter is a scissor-type knife used in endoscopic submucosal dissection(ESD)for gastrointestinal tract tumors.The assistant during the ESD using a clutch cutter(ESD-C)needs to rotate the device and grasp the target tissue appropriately;therefore,the assistant’s skill may affect the technical outcomes of ESD-C.AIM To determine how assistant skill level affected the technical outcomes of gastric ESD-C using an ex vivo porcine training model.METHODS In this pilot study,mock lesions of 15-30 mm in diameter were created in the middle or lower third of the porcine stomach.A total of 32 ESD-C procedures were performed by 16 trainees.Each trainee operator performed two ESD-C procedures;one ESD-C was assisted by an expert(ESD-C-E),and the other was assisted by a non-expert(ESD-C-NE).The total procedure time of the ESD was set as the primary outcome,and en bloc resection rate,complete procedure rate,perforation rate,and each procedure time/speed for mucosal incision or submucosal dissection were set as the secondary outcomes.In addition,we investigated factors associated with the difficulty of ESD including incompletion of ESD procedure,a long procedure time(≥20 min)or intraoperative perforation.RESULTS The median total procedure time of the ESD-C-E was significantly shorter than that of the ESD-C-NE(12.9 min vs 21.9 min,P=0.001).The en bloc resection rate was 100%in both groups.Complete resection rates of the ESD-C-E and ESD-C-NE groups were 100%and 93.8%,respectively.No intraoperative perforation was observed in both groups.In the multivariate analysis,assistant skill was significantly associated with the difficulty of ESD,with the highest odds ratio of 16.5.CONCLUSION Assistance by an expert is an important factor when trainees perform ESD-C procedures. | Mitsuru Esaki Toshiki Horii Ryoji Ichijima Masafumi Wada Seiichiro Sakisaka Shuichi Abe Naru Tomoeda Yusuke Kitagawa Kei Nishioka Yosuke Minoda Shinichi Tsuruta Sho Suzuki Hirotada Akiho Eikichi Ihara Yoshihiro Ogawa Takuji Gotoda | 2021 | World Journal of Gastrointestinal Surgery2021，13，2： | 1 |
| 13 | The effect of granulocyte and monocyte adsorptive apheresis on serum cytokine levels in patients with ulcerative colitis显示文摘 | Yosuke Toya Toshimi Chiba Tomomi Mizutani Kunihiko Sato Satoshi Kasugai Nozomi Matsuda Shunsuke Orikasa Sho Shibata Yukito Abiko Risaburo Akasaka Naoki Yokoyama Shuhei Oana Shigeru Hirota Masaki Endo Kazuyuki Suzuki | 2013 | Cytokine2013，，： | 1 |
| 14 | Efficacy and safety of grasping forceps-assisted endoscopic resection for gastric neoplasms:A multi-centre retrospective study显示文摘BACKGROUND Endoscopic submucosal dissection(ESD)is widely accepted for early gastric cancer(EGC)without lymph node metastasis,although ESD is challenging,even for small lesions,in the greater curvature(GC)of the upper(U)and middle(M)thirds of the stomach.Grasping forceps-assisted endoscopic resection(GF-ER)is a type of endoscopic mucosal resection that is performed via a double-channel endoscope.AIM To investigate the safety and efficacy of GF-ER vs ESD in the GC of the stomach’s U and M regions.METHODS We retrospectively reviewed the medical records of 506 patients who underwent ER of 522 EGC lesions in the stomach’s U and M regions in three institutions between January 2016 and May 2020.Nine lesions from eight patients who underwent GF-ER for EGC(the GF-ER group)were compared to 63 lesions from 63 patients who underwent ESD(the ESD group).We also performed a subgroup analysis of small lesions(≤10 mm)in 6 patients(7 lesions)from the GF-ER group and 20 patients(20 lesions)from the ESD group.RESULTS There were no statistically significant differences between the GF-ER and ESD groups in the en bloc resection rates(100%vs 100%)and the R0 resection rates(100%vs 98.4%).The median procedure time in the GF-ER group was shorter than that in the ESD group(4.0 min vs 55.0 min,P<0.01).There were no adverse events in the GF-ER group,although five perforations(8.0%)and 1 case of postoperative bleeding(1.6%)were observed in the ESD group.When we only considered lesions that were≤10 mm,the median procedure time in the GF-ER group was still shorter than that in the ESD group(4.0 min vs 35.0 min,P<0.01).There were no adverse events in the GF-ER group,although 1 case of perforation(1.6%)were observed in the ESD group.CONCLUSION These findings suggest that GF-ER may be an effective therapeutic option for small lesions in the GC of the stomach’s U and M regions. | Ryoji Ichijima Sho Suzuki Mitsuru Esaki Toshiki Horii Chika Kusano Hisatomo Ikehara Takuji Gotoda | 2021 | World Journal of Gastrointestinal Oncology2021，13，3： | 0 |
| 15 | A COMPREHENSIVE SOFTWARE SUITE FOR THE ANALYSIS OF CDNAS显示文摘We have developed a comprehensive software suite for bioinformatics research of cDNAs; it is aimed at rapid characterization of the features of genes and the pro- teins they code. Methods implemented include the detection of translation initia- tion and termination signals, statistical analysis of codon usage, comparative study of amino acid composition, comparative modeling of the structures of product pro- teins, prediction of alternative splice forms, and metabolic pathway reconstruction. The software package is freely available under the GNU General Public License at http://www.g-language.org/data/cdna/. | KAZUHARU ARAKAWA HARUO SUZUKI KOSUKE FUJISHIMA KENJI FUJIMOTO SHO UEDA MOTOMU MATSUI MASARU TOMITA | 2005 | Genomics, Proteomics & Bioinformatics2005，3，3： | 0 |
| 16 | Predictive model of risk factors of High Flow Nasal Cannula using machine learning in COVID-19显示文摘With the rapid increase in the number of COVID-19 patients in Japan,the number of patients receiving oxygen at home has also increased rapidly,and some of these patients have died.An efficient approach to identify high-risk patients with slowly progressing and rapidly worsening COVID-19,and to avoid missing the timing of therapeutic intervention will improve patient prognosis and prevent medical complications.Patients admitted to medical institutions in Japan from November 14,2020 to April 11,2021 and registered in the COVID-19 Registry Japan were included.Risk factors for patients with High Flow Nasal Cannula invasive respiratory management or higher were comprehensively explored using machine learning.Age-specific cohorts were created,and severity prediction was performed for the patient surge period.We were able to obtain a model that was able to predict severe disease with a sensitivity of 57%when the specificity was set at 90%for those aged 40e59 years,and with a specificity of 50%and 43%when the sensitivity was set at 90%for those aged 60e79 years and 80 years and older,respectively.We were able to identify lactate dehydrogenase level(LDH)as an important factor in predicting the severity of illness in all age groups.Using machine learning,we were able to identify risk factors with high accuracy,and predict the severity of the disease.We plan to develop a tool that will be useful in determining the indications for hospitalisation for patients undergoing home care and early hospitalisation. | Nobuaki Matsunaga Keisuke Kamata Yusuke Asai Shinya Tsuzuki Yasuaki Sakamoto Shinpei Ijichi Takayuki Akiyama a Jiefu Yu Gen Yamada Mari Terada Setsuko Suzuki Kumiko Suzuki Sho Saito Kayoko Hayakawa Norio Ohmagari | 2022 | Infectious Disease Modelling2022，7，3： | 0 |
| 17 | Clinical prediction of complicated appendicitis:A case-control study utilizing logistic regression显示文摘BACKGROUND Since high-quality evidence on conservative treatment of acute appendicitis using antibiotics has increased,differentiation of patients with complicated appendicitis(CA)from those with simple appendicitis(SA)has become increasingly important.Previous studies have revealed that male gender,advanced age,comorbid conditions,prehospital delay,fever,and anorexia are risk factors of perforated appendicitis.Elevated serum C-reactive protein(CRP)level and hyponatremia have also been reported as predictive biomarkers of CA.However,confounding between various factors is problematic because most previous studies were limited to univariate analysis.AIM To evaluate non-laboratory and laboratory predictive factors of CA using logistic regression analyses.METHODS We performed an exploratory,single-center,retrospective case-control study that evaluated 198 patients(83.9%)with SA and 38 patients(16.1%)with CA.Diagnoses were confirmed by computed tomography images for all cases.We compared age,sex,onset-to-visit interval,epigastric/periumbilical pain,right lower quadrant pain,nausea/vomiting,diarrhea,anorexia,medical history(of previous non-surgically treated appendicitis,diabetes,hypertension,dyslipidemia,liver cirrhosis,hemodialysis,chronic lung diseases,malignant tumors,immunosuppressant use,and antiplatelet use),vital signs,physical findings,and laboratory data to select the explanatory variates for logistic regression.Based on the univariate comparisons,we performed logistic regression for clinical differentiation between CA and SA using only nonlaboratory factors and also including both non-laboratory and laboratory factors.RESULTS The 236 eligible patients consisted of 198 patients(83.9%)with SA and 38 patients(16.1%)with CA.The median ages were 34 years old[interquartile ranges(IR),24-45 years]in the SA group and 49 years old(IR,35-63 years)in the CA group(P<0.001).The median onset-to-visit interval was 1 d(IR,0-1)and 1 d(IR,1-2)in the SA and CA groups,respectively(P<0.001).Heart rate,body temperature,and serum CRP level in the CA group were significantly higher than in the SA group;glomerular filtration rate and serum sodium were significantly lower in the CA group.Anorexia was significantly more prevalent in the CA group.The regression model including age,onset-to-visit interval,anorexia,tachycardia,and fever as non-laboratory predictive factors of CA(Model 1)showed that age≥65 years old,longer onset-to-visit interval,and anorexia had significantly high odds ratios.The logistic regression for prediction of CA including age,onset-to-visit interval,anorexia,serum CRP level,hyponatremia(serum sodium<135 mEq/L),and glomerular filtration rate<60 mL/min/1.73 m2(Model 2)showed that only elevated CRP levels had significantly high odds ratios.Under the curve values of receiver operating characteristics curves of each regression model were 0.74 for Model 1 and 0.87 for Model 2.CONCLUSION Our logistic regression analysis on differentiating factors of CA from SA showed that high CRP level was a strong dose-dependent predictor of CA. | Yosuke Sasaki Fumiya Komatsu Naoyasu Kashima Takeshi Suzuki Ikutaka Takemoto Sho Kijima Tadashi Maeda Taito Miyazaki Yoshiko Honda Hiroaki Zai Nagato Shimada Kimihiko Funahashi Yoshihisa Urita | 2020 | World Journal of Clinical Cases2020，8，11： | 0 |
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