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  • Special Article 2024-07-25 2024-07-25 \ 0 \ 446 \ 222

    A New Korean Nomenclature for Steatotic Liver Disease

    Nonalcoholic Fatty Liver Disease (NAFLD) Nomenclature Revision Consensus Task Force on behalf of the Korean Association for the Study of the Liver (KASL)

  • Review Article 2024-07-25 2024-07-25 \ 0 \ 685 \ 388

    Upper GI Tract

    Treatment Strategies for Gastric Cancer Patients with Gastric Outlet Obstruction

    Hyun Lim

    Abstract
    Gastric cancer frequently leads to gastric outlet obstruction (GOO), causing significant symptoms and complications. Surgical bypass and stenting are two representative palliative treatments for GOO by gastric cancer. This study reviews clinical guidelines for malignant GOO treatment, highlighting differences in recommendations based on patient survival expectations and systemic health. A meta-analysis of surgical bypass and stenting in gastric cancer patients revealed no significant difference in technical and clinical success rates between the two treatments. However, stenting allowed faster resumption of oral intake and shorter hospital stays but had higher rates of major complications and reobstruction. Despite these differences, overall survival did not significantly differ between the two groups. Emerging techniques like EUS-guided gastrojejunostomy show promise but require further research and experienced practitioners. Ultimately, treatment should be tailored to patient preferences and the specific benefits and drawbacks of each method to improve quality of life and outcomes.
  • Original Article 2024-07-25 2024-07-25 \ 0 \ 398 \ 234

    Liver

    Etiology and Outcomes of Patients with Extreme Hyperbilirubinemia in Korea: A Retrospective Cohort Study

    Ji Yoon Kwak1,2,3*, Hankyu Jeon1,2,3*, Seong Je Kim3, Ji Hee Han1,2,3, Ra Ri Cha1,2,3, Sang Soo Lee1,2,3

    Abstract
    Background/Aim: Extreme hyperbilirubinemia is occasionally observed in intensive care unit (ICU) and non-ICU settings. This study examined the etiologies of extreme hyperbilirubinemia (bilirubin level ≥12 mg/dL) and the factors associated with the 30-day mortality.
    Methods: This retrospective observational cohort study identified 439 patients with extreme hyperbilirubinemia at the Gyeongsang National University Changwon Hospital between 2016 and 2020. The patients were classified into three groups and 11 diseases according to their etiology. The risk factors associated with 30-day mortality at the baseline were investigated using the Cox proportional hazards model.
    Results: Of 439 patients with extreme hyperbilirubinemia, 287, 78, and 74 were in the liver cirrhosis/malignancy group, the ischemic injury group, and the benign hepatobiliary-pancreatic etiological group, respectively, with corresponding 30-day mortality rates of 42.9%, 76.9%, and 17.6%. The most common disease leading to hyperbilirubinemia was a pancreatobiliary malignancy (28.7%), followed by liver cirrhosis (17.3%), hepatocellular carcinoma (10.9%), and liver metastases (8.4%). The etiologies of hyperbilirubinemia, obstructive jaundice, infection, albumin level, creatinine level, and prothrombin time-international normalized ratio were independently associated with the 30-day mortality.
    Conclusions: This study suggests three etiologies of extreme hyperbilirubinemia in the ICU and non-ICU settings. The prognosis of patients with extreme hyperbilirubinemia depends largely on the etiology and the presence of obstructive jaundice.
  • Original Article 2024-07-25 2024-07-25 \ 1 \ 405 \ 220

    Lower GI Tract

    Impact of Dementia in Colorectal Cancer Patients: United States Population-Based Cohort Study

    Thanathip Suenghataiphorn1 , Narathorn Kulthamrongsri2, Pojsakorn Danpanichkul3, Sakditad Saowapa3, Natchaya Polpichai4, Jerapas Thongpiya3

    Abstract
    Background/Aims: Various socioeconomic and racial disparities are well-documented for colon cancer. However, the association of dementia, which is a growing cause of mortality in the elderly, remains unexplored. We aim to understand the association between these two conditions, in the elderly population group.
    Methods: We utilized the 2020 National Inpatient Sample to investigate records admitted for colorectal cancer identified through ICD-10 CM codes. We divided records by the presence of dementia. Adjusted odds ratios (aORs) for predefined outcomes were determined using multivariable logistic and linear regression models, adjusting for comorbidities. The primary outcome assessed was inpatient mortality, while secondary outcomes include other inpatient complications.
    Results: We identified 33,335 hospitalizations with ages more than 60. The mean age was 75.2 and males constituted 50.4%. In a survey multivariable logistic and linear regression model adjusting for patient and hospital factors, utilizing propensity score matching, the presence of dementia is associated with lower inpatient mortality (aOR 0.49, 95% confidence interval [CI] [0.26, 0.92], p=0.03), lower hospitalization costs (beta coefficient -2,823, 95% CI [-5,266, -440], p=0.02), lower odds of acute respiratory failure (aOR 0.54, p=0.01), lower mechanical ventilation usage (aOR 0.26, p<0.01) but higher odds of mental status change (aOR 1.97, 95% CI [1.37, 2.84], p<0.01).
    Conclusions: The presence of dementia is associated with a lower risk of inpatient mortality, and other clinical outcomes, in colorectal cancer cases admitted for hospitalization. Etiologies behind this relationship should be explored to understand this inverse relationship.
The Korean Society of Gastroenterology

Vol.85 No.1
January 2025

pISSN 1598-9992
eISSN 2233-6869
Frequency: Quarterly

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