Cholelithiasis prevalence and risk factors in individuals with severe or profound intellectual and motor disabilities

• Published in: Journal of intellectual disability research Vol. 68; no. 4; pp. 317 - 324
• Main Authors: Watanabe, A, Tomioka, Y, Okata, Y, Yoshimura, S, Kumode, S, Iwabuchi, S, Kameoka, Y, Takanarita, Y, Uemura, K, Samejima, Y, Kawasaki, Y, Bitoh, Y
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2024
• Subjects: Age differences; Constipation; Enteral nutrition; Gallstones; Health care; Medical screening; Medical Services; Motor ability; Nutrition; Ostomy; Patients; Prevalence; Risk factors; Sex differences; Tomography; Treatment methods; Ultrasonic imaging; Ventilators; severe or profound intellectual and motor disabilities; prevalence; risk factor; gallstones
• ISSN: 0964-2633; 1365-2788
• DOI: 10.1111/jir.13113

The prevalence and risk factors of cholelithiasis in individuals with severe or profound intellectual and motor disabilities (SPIMD) are poorly characterised. Thus, we aimed to investigate the prevalence and risk determinants of cholelithiasis in a cohort with SPIMD under medical care in a residential facility. We categorised 84 patients in a residential hospital for persons with SPIMD into groups: those with (Group CL) and without (Group N) cholelithiasis. Gallstones were detected via computed tomography, ultrasonography or both. We evaluated gastrostomy status, nutritional and respiratory support, constipation, and bladder and kidney stones. Data were significantly analysed using univariate and multivariate logistic regression analyses. The prevalence rate of cholelithiasis in our SPIMD cohort was 27%. There were no significant differences in sex, age, weight, height, or Gross Motor Function Classification System between the two groups. However, more patients received enteral nutrition (39.13% vs. 6.56%; P = 0.000751) and were on ventilator support (56.52% vs. 19.67%; P = 0.00249) in Group CL than in Group N. Enteral nutrition [odds ratio (OR) 10.4, 95% confidence interval (CI) 1.98-54.7] and ventilator support (OR 20.0, 95% CI 1.99-201.0) were identified as independent risk factors for the prevalence of cholelithiasis in patients with SPIMD. Patients with SPIMD demonstrated an increased prevalence of cholelithiasis, with a notable association between nutritional tonic use and respiratory support. Therefore, to emphasise the need for proactive screening, it is crucial to devise diagnostic and therapeutic strategies specific to patients with SPIMD. Further investigation is essential to validate our findings and explore causative factors.