OBJECTIVE: To evaluate the effect of GLP-1 RAs on gastric residual contents during endoscopic procedures.
METHODS: A retrospective chart review at BronxCare Health System, New York, from January 2019 to October 2023, assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic procedures. Two groups were compared based on dietary status before the procedure. Data included demographics, symptoms of gastroparesis, opiate use, hemoglobin A1c, GLP-1 agonist indication, endoscopic details, and aspiration occurrence. IBM SPSS was used for analysis, calculating means, standard deviations, and applying Pearson\'s chi-square and t-tests for associations, with P < 0.05 as being significant.
RESULTS: During the study, 306 patients were included, with 41.2% on a clear liquid/low residue diet and 58.8% on a regular diet before endoscopy. Most patients (63.1%) were male, with a mean age of 60 ± 12 years. The majority (85.6%) were on GLP-1 RAs for diabetes, and 10.1% reported digestive symptoms before endoscopy. Among those on a clear liquid diet, 1.5% had residual food at endoscopy compared to 10% on a regular diet, which was statistically significant (P = 0.03). Out of 31 patients with digestive symptoms, 13% had residual food, all from the regular diet group (P = 0.130). No complications were reported during or after the procedures.
CONCLUSIONS: The study reflects a significant rise in GLP-1 RA use for diabetes and obesity. A 24-hour liquid diet seems safe for endoscopic procedures without aspiration. Patients with upper gastrointestinal symptoms might have a higher residual food risk, though not statistically significant. Further research is needed to assess risks based on diabetes duration, gastroparesis, and GLP-1 RA dosing, aiming to minimize interruptions in therapy during procedures.
目的:评价GLP-1RAs对胃镜下残余内容物的影响。
方法:BronxCare卫生系统的回顾性图表回顾,纽约,从2019年1月至2023年10月,我们评估了接受内镜手术的GLP-1RA患者的胃残留和误吸.根据手术前的饮食状况对两组进行比较。数据包括人口统计,胃轻瘫的症状,阿片类药物的使用,血红蛋白A1c,GLP-1激动剂适应症,内窥镜细节,和误吸发生。IBMSPSS用于分析,计算手段,标准偏差,并应用皮尔逊卡方检验和t检验进行关联,P<0.05为显著。
结果:在研究期间,包括306名患者,在内窥镜检查前,41.2%的饮食是透明的液体/低残留饮食,58.8%的饮食是常规饮食。大多数患者(63.1%)为男性,平均年龄60±12岁。大多数(85.6%)在GLP-1RA用于糖尿病,10.1%的患者在内窥镜检查前报告了消化症状。在那些清流饮食的人中,1.5%的人在内窥镜检查时残留食物,而常规饮食为10%。有统计学意义(P=0.03)。31例有消化症状的病人中,13%有残留食物,均来自常规饮食组(P=0.130)。术中或术后均未报告并发症。
结论:该研究反映了GLP-1RA用于糖尿病和肥胖症的显著增加。对于没有抽吸的内窥镜手术,24小时流质饮食似乎是安全的。有上消化道症状的患者可能有更高的残留食物风险,虽然没有统计学意义。需要进一步的研究来评估基于糖尿病持续时间的风险,胃轻瘫,和GLP-1RA给药,旨在尽量减少手术过程中的治疗中断。