The Incidence, Prevalence, and Survival of Gastroparesis in Olmsted County, Minnesota, 1996-2006 (Gastroenterology 2009;136:1225-1233)

Abstract

Sum m ary Population-based studies of the gastroparesis are lacking, therefore, authors aimed to determine the incidence and prevalence and outcome of gastroparesis in the community. Using the Rochester Epidemiology Project (REP), a medical records linkage system in Olmsted County, Minnesota, they identified county residents with potential gastroparesis. All county residents diagnosed with gastroparesis were identified by the diagnostic index developed by the REP or registration data to identify all residents of Olmsted County who have had their gastric emptying assessed. The complete medical records were reviewed by gastro-enterologist to verify the diagnosis. Three diagnostic definitions were used: 1) definite gastroparesis: delayed gastric emptying by standard scintigraphy and symptoms of nausea and/or vomiting, postprandial fullness, early satiety, bloating, or epigastric pain for more than 3 months 2) probable gastroparesis: symptoms and food retention on endoscopy or upper GI study but no scintig-raphy 3) possible gastroparesis: typical symptoms alone or delayed gastric emptying by scintigraphy without GI symptoms. Poisson regression was used to assess the association of incidence rates with age, gender, and calendar period. Among 222 eligible cases of gastroparesis, 83 patients met diagnostic criteria for definite ; probable 44, and possible 95. 68 out of 83 patients with definite gastroparesis were female (82%). The mean age (± SD) of definite gastroparesis was 44 (± 21) years. The most possible causes of definite gastroparesis were diabetes mellitus in 18 patients (21.7%), 5 connective tissue disease (6.0%), post-surgical gastroparesis in 3 patients (3.6%), malignancy in 2 patients (2.4%), psychiatric illnesses in 5 patients (6%), provocation drugs in 4 (4.8%). Idiopathic gastroparesis was 42 (50.6%). The age-adjusted (to 2000 U.S. whites) incidence per 100,000 person years of definite gastroparesis for the years 1996-2006 was 9.8 (95% confidence interval (CI), 7.5-12.1) for women and 2.4 (95% CI, 1.2-3.8) for men. The age-adjusted prevalence of definite gastroparesis per 100,000 person was 37.8 (95% CI, 23.3-52.4) for women and 9.6 (95% CI, 1.8-17.4) for men. Poisson regression indicated significantly increasing rates with age and for females (both p ＜ 0.001) but no effect of calendar period. The estimated 5-year survival of the cohort of definite + probable + possible gastroparesis was 67% (95% CI, 60-75%), compared with an expected 81% in the age-and gender-matched population (p < 0.01).