{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T21:22:21Z","timestamp":1783545741127,"version":"3.55.0"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Early identification of patients needing hospital\u2010specific interventional care (HIC) following endoscopic treatment is valuable for optimizing postoperative hospital stays. We aimed to develop and validate a risk\u2010scoring system for predicting HIC in patients who underwent peroral endoscopic myotomy (POEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included patients with esophageal motility disorders who underwent POEM at our hospital between April 2015 and March 2023. HIC was defined as any of the following situations: fasting for gastrointestinal rest to manage adverse events (AEs); intravenous administration of medications such as antibiotics and blood transfusion; endoscopic, radiologic, and surgical interventions; intensive care unit management; or other life\u2010threatening events. A risk\u2010scoring system for predicting HIC after postoperative day (POD) 1 was developed using multivariable logistic regression and was internally validated using bootstrapping and decision curve analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 589 patients, 50 (8.5%) experienced HIC after POD1. Risk scores were assigned for four factors as follows: age (0 points for &lt;70\u2009years, 1 point for 70\u201379\u2009years, 2 points for \u226580\u2009years), preoperative prognostic nutritional index (0 points for &gt;45, 1 point for 40\u201345, 4 points for &lt;40), postoperative surgical site AEs on second\u2010look endoscopy (7 points), and postoperative pneumonia on chest radiography (6 points). The discriminative ability (concordance statistics, 0.85; 95% confidence interval, 0.78\u20130.91) and calibration (slope 1.00; 0.74\u20131.28) were satisfactory. The decision curve analysis demonstrated its clinical usefulness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This risk\u2010scoring system can predict the HIC after POD1 and provide useful information for determining discharge.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14909","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T08:58:32Z","timestamp":1725267512000},"page":"247-256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk\u2010scoring system predicting need for hospital\u2010specific interventional care after peroral endoscopic myotomy"],"prefix":"10.1111","volume":"37","author":[{"given":"Hirofumi","family":"Abe","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3714-8565","authenticated-orcid":false,"given":"Shinwa","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroya","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chise","family":"Ueda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Hori","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Nakai","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-4766","authenticated-orcid":false,"given":"Tetsuya","family":"Yoshizaki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiaki","family":"Kawara","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Konan Medical Center  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Toyonaga","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Kobe University Hospital  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kinoshita","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Urakami","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Hoki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzo","family":"Kodama","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine Kobe University Graduate School of Medicine  Hyogo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1244080"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30296-X"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13770"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.04.247"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07781-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07866-0"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.05.005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0698"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeu100"},{"key":"e_1_2_9_11_1","first-page":"1001","article-title":"Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients","volume":"85","author":"Onodera T","year":"1984","journal-title":"J Jpn Surg Soc"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-017-0589-1"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318225c2be"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws412"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201808-564PS"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1742"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.13686"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-020-06775-5"}],"container-title":["Digestive Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.14909","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T08:52:38Z","timestamp":1741769558000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/den.14909"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,2]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/den.14909"],"URL":"https:\/\/doi.org\/10.1111\/den.14909","archive":["Portico"],"relation":{},"ISSN":["0915-5635","1443-1661"],"issn-type":[{"value":"0915-5635","type":"print"},{"value":"1443-1661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,2]]},"assertion":[{"value":"2024-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}