European Bacterial Vaginosis Therapy Getting US Attention European Bacterial Vaginosis Therapy Getting US Attention
May 9, 2024Jumpstart Your AI Learning: The Very Best Resources for Docs Jumpstart Your AI Learning: The Very Best Resources for Docs
May 9, 2024TOPLINE:
Encountering retained gastric contents during esophagogastroduodenoscopy (EGD) is more common in patients taking glucagon-like peptide 1 receptor agonists (GLP-1 RAs) but rarely leads to procedure abortion or aspiration, new data from the Cleveland Clinic showed.
METHODOLOGY:
- Currently, recommendations on how to handle EGD in patients taking GLP-1 RAs for type 2 diabetes or obesity vary, due largely to a lack of outcomes data from which to draw evidence-based conclusions.
- Researchers performed a retrospective analysis of 1512 index EGDs performed on patients taking GLP-1 RAs.
- Data were extracted using a combination of diagnosis codes, procedure codes, and natural language processing and refined by manual chart review.
- The primary outcome was the rate of retained gastric contents encountered during EGD. The secondary outcomes included rates of aborted procedures, repeat procedures, and adverse events, with a focus on aspiration.
TAKEAWAY:
- Of the 1512 EGDs included, 142 (9.4%) had retained gastric contents, primarily solid residue (78.9%). The prevalence of retained gastric contents was higher (11.6%) in the EGDs performed to evaluate upper gastrointestinal symptoms.
- Endoscopy was aborted in 30 cases (2.0%); 29 had retained gastric contents. Many also required repeat EGD.
- Despite the high rate of retained gastric contents, aspiration risk remained low (two cases; 0.1%) — only marginally higher than the rate among the general population. Other adverse events included four cases (0.3%) of intraprocedural hypoxia and one each of abdominal pain, bronchospasm, and cholangitis, which were all categorized as mild.
- On multivariate analysis, younger age was associated with a higher risk for retained gastric contents.
IN PRACTICE:
The authors wrote that their observations support “the [American Gastroenterological Association] recommendation endorsing a liquid diet the day before endoscopy in lieu of holding [GLP-1 RAs].”
SOURCE:
The study, with first author Stephen A. Firkins, MD, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Ohio, was published online in Clinical Gastroenterology and Hepatology.
LIMITATIONS:
The authors did not state any specific limitations.
DISCLOSURES:
The study had no specific funding. The authors disclosed no conflicts of interest.