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A Simple Risk Scoring System for Predicting the Occurrence of Aspiration Pneumonia After Gastric Endoscopic Submucosal Dissection

DC Field Value Language
dc.contributor.author김기준-
dc.contributor.author김나영-
dc.contributor.author김소연-
dc.contributor.author채동우-
dc.date.accessioned2022-03-11T06:21:48Z-
dc.date.available2022-03-11T06:21:48Z-
dc.date.issued2022-01-
dc.identifier.issn0003-2999-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/188053-
dc.description.abstractBackground: Aspiration pneumonia after endoscopic submucosal dissection (ESD) is rare, but can be fatal. We aimed to investigate risk factors and develop a simple risk scoring system for aspiration pneumonia. Methods: We retrospectively reviewed medical records of 7833 patients who underwent gastric ESD for gastric neoplasm under anesthesiologist-directed sedation. Candidate risk factors were screened and assessed for significance using a least absolute shrinkage and selection operator (LASSO)-based method. Top significant factors were incorporated into a multivariable logistic regression model, whose prediction performance was compared with those of other machine learning models. The final risk scoring system was created based on the estimated odds ratios of the logistic regression model. Results: The incidence of aspiration pneumonia was 1.5%. The logistic regression model showed comparable performance to the best predictive model, extreme gradient boost (area under receiver operating characteristic curve [AUROC], 0.731 vs 0.740). The estimated odds ratios were subsequently used for the development of the clinical scoring system. The final scoring system exhibited an AUROC of 0.730 in the test dataset with risk factors: age (≥70 years, 4 points), male sex (8 points), body mass index (≥27 kg/m2, 4 points), procedure time (≥80 minutes, 5 points), lesion in the lower third of the stomach (5 points), tumor size (≥10 mm, 3 points), recovery time (≥35 minutes, 4 points), and desaturation during ESD (9 points). For patients with total scores ranging between 0 and 33 points, aspiration pneumonia probabilities spanned between 0.1% and 17.9%. External validation using an additional cohort of 827 patients yielded AUROCs of 0.698 for the logistic regression model and 0.680 for the scoring system. Conclusions: Our simple risk scoring system has 8 predictors incorporating patient-, procedure-, and sedation-related factors. This system may help clinicians to stratify patients at risk of aspiration pneumonia after ESD.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherLippincott Williams & Wilkins-
dc.relation.isPartOfANESTHESIA AND ANALGESIA-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAged-
dc.subject.MESHArea Under Curve-
dc.subject.MESHEndoscopic Mucosal Resection / adverse effects*-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHIncidence-
dc.subject.MESHMachine Learning-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultivariate Analysis-
dc.subject.MESHPneumonia, Aspiration / diagnosis*-
dc.subject.MESHPneumonia, Aspiration / etiology*-
dc.subject.MESHPostoperative Complications-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHProbability-
dc.subject.MESHROC Curve-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk-
dc.subject.MESHRisk Assessment / standards*-
dc.subject.MESHRisk Factors-
dc.subject.MESHStomach / surgery-
dc.subject.MESHStomach Neoplasms / complications*-
dc.subject.MESHStomach Neoplasms / surgery*-
dc.titleA Simple Risk Scoring System for Predicting the Occurrence of Aspiration Pneumonia After Gastric Endoscopic Submucosal Dissection-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology and Pain Medicine (마취통증의학교실)-
dc.contributor.googleauthorKyemyung Park-
dc.contributor.googleauthorNa Young Kim-
dc.contributor.googleauthorKi Jun Kim-
dc.contributor.googleauthorChaerim Oh-
dc.contributor.googleauthorDongwoo Chae-
dc.contributor.googleauthorSo Yeon Kim-
dc.identifier.doi10.1213/ANE.0000000000005779-
dc.contributor.localIdA00340-
dc.contributor.localIdA00348-
dc.contributor.localIdA00616-
dc.contributor.localIdA04014-
dc.relation.journalcodeJ00144-
dc.identifier.eissn1526-7598-
dc.identifier.pmid34673667-
dc.identifier.urlhttps://journals.lww.com/anesthesia-analgesia/Fulltext/2022/01000/A_Simple_Risk_Scoring_System_for_Predicting_the.17.aspx-
dc.contributor.alternativeNameKim, Ki Jun-
dc.contributor.affiliatedAuthor김기준-
dc.contributor.affiliatedAuthor김나영-
dc.contributor.affiliatedAuthor김소연-
dc.contributor.affiliatedAuthor채동우-
dc.citation.volume134-
dc.citation.number1-
dc.citation.startPage114-
dc.citation.endPage122-
dc.identifier.bibliographicCitationANESTHESIA AND ANALGESIA, Vol.134(1) : 114-122, 2022-01-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers

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