剥脱性食管炎：一种与衰弱和多药治疗相关的自限性疾病？一项大样本分析。

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中文摘要

背景： 剥脱性食管炎被认为影响老年、衰弱个体，尤其是伴有合并症者。其典型表现为内镜下肉眼可见的白色斑块或膜状物，组织学诊断依据为受损细胞剥脱而下方黏膜正常。
目的： 我们旨在描述迄今最大队列中剥脱性食管炎的临床表现和相关性。
研究： 检索大型机构数据库以确定剥脱性食管炎诊断患者。审查相应的内镜报告。从电子病历中提取病史和病程数据。
结果： 我们识别出115例剥脱性食管炎患者。最常见的EGD指征为吞咽困难（31%）。47%存在典型内镜表现。平均Charlson合并症指数评分为4.1，个体平均处方12.3种药物。建议25例（22%）个体入住SNF，84例（78%）在诊断后存活≥2年。症状和内镜表现分别有77%和83%的病例缓解，且与治疗使用无关。
讨论： 剥脱性食管炎的内镜表现多变，并与衰弱和多药治疗相关。它可能无需药物治疗而自行缓解，这可能提示一种短暂、自限性的临床病程。

英文摘要

BACKGROUND: Sloughing esophagitis is thought to affect older, debilitated individuals, especially with comorbid disease. It classically exhibits white endoscopic plaques or membranes grossly and is diagnosed histologically by the sloughing of damaged cells with normal underlying mucosa.
GOALS: We sought to describe the clinical manifestations and associations of sloughing esophagitis in the largest cohort to date.
STUDY: A large institutional database was searched for a diagnosis of sloughing esophagitis to identify patients. Corresponding endoscopy reports were reviewed. Historical and disease course data was extracted from the electronic medical record.
RESULTS: We identified 115 individuals with sloughing esophagitis. The most common EGD indication was dysphagia (31%). Classic endoscopic findings were present in 47%. The average Charlson comorbidity index score was 4.1, and individuals were prescribed 12.3 medications on average. SNF placement was recommended for 25 (22%) individuals, and 84 (78%) survived for ≥2 years following diagnosis. Symptoms and endoscopic findings resolved in 77% and 83% of cases, respectively, which was independent of treatment utilization.
DISCUSSION: Sloughing esophagitis has a variable endoscopic appearance and is associated with debilitation and polypharmacy. It may resolve spontaneously without pharmacotherapy, which may suggest a transient, self-limiting clinical course.