Epidemiology and Healthcare Utilization in Patients With Gastroparesis: A Systematic Review,Clinical Gastroenterology and Hepatology

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Epidemiology and Healthcare Utilization in Patients With Gastroparesis: A Systematic Review
Clinical Gastroenterology and Hepatology ( IF 11.6 ) Pub Date : 2022-07-20 , DOI: 10.1016/j.cgh.2022.07.011
Saam Dilmaghani ₁ , Ting Zheng ₁ , Michael Camilleri ₁

Affiliation

Background & Aims

The authors performed a systematic review of epidemiologic data to understand the prevalence, incidence, etiologies, and hospitalizations related to gastroparesis (GP).

Methods

Studies of the epidemiology of GP published in all languages, years, and countries from 5 databases in January 2022 were studied using prespecified search strategies.

Results

Thirteen studies (data from 1994 to 2019) were included. All but one study (from the United Kingdom) were based in the United States. Prevalence of definite GP (symptoms plus delayed gastric emptying) ranged from 13.8 to 267.7 per 100,000 adults, and incidence was 1.9–6.3 per 100,000 person-years. The estimated 10-year cumulative incidence of GP in type 1 diabetes (DM) and type 2 DM was 5.2% and 1.0%, respectively. Across studies, GP was more common among female patients and those with DM. Rates of hospitalizations and emergency department visits for GP are increasing, ranging from 2- to 18-fold over approximately 2 decades. Mortality rates for patients with possible or definite GP were higher compared with the general population, with primary causes of death in GP being cardiovascular, respiratory failure, and malignancy. Multiple studies observed improved inpatient mortality over the mid-1990s to late 2000s. Limitations include the case identification in most studies (76.9%) used solely International Classification of Diseases codes or clinical record diagnoses; 2 studies (15.4%) used objective evaluation to diagnose GP. Only 4 studies (30.8%) used non-specialized community databases; the remaining 9 studies used inpatient, emergency department, or disease-specific databases.

Conclusions

There is a paucity of high-quality, demographically diverse, and population-based studies to accurately describe the epidemiology of GP. Future studies with valid gastric emptying measurement are needed to better characterize the epidemiology and natural history of GP.

中文翻译：

胃轻瘫患者的流行病学和医疗保健利用：系统评价

背景与目标

作者对流行病学数据进行了系统回顾，以了解与胃轻瘫 (GP) 相关的患病率、发病率、病因和住院情况。

方法

使用预先指定的搜索策略对 2022 年 1 月 5 个数据库中以所有语言、年份和国家发表的 GP 流行病学研究进行了研究。

结果

纳入了 13 项研究（1994 年至 2019 年的数据）。除一项研究（来自英国）外，所有研究均在美国开展。明确的 GP（症状加上胃排空延迟）的患病率范围为每 100,000 名成人 13.8 至 267.7 人，发病率为每 100,000 人年 1.9-6.3。 1 型糖尿病 (DM) 和 2 型 DM 中 GP 的 10 年累积发病率估计分别为 5.2% 和 1.0%。各项研究显示，GP 在女性患者和糖尿病患者中更为常见。全科医生的住院率和急诊科就诊率不断增加，在大约 20 年间增加了 2 至 18 倍。与普通人群相比，可能或确诊的 GP 患者的死亡率较高，其中 GP 死亡的主要原因是心血管、呼吸衰竭和恶性肿瘤。多项研究观察到 20 世纪 90 年代中期至 2000 年代末住院患者死亡率有所改善。局限性包括大多数研究（76.9%）仅使用国际疾病分类代码或临床记录诊断进行病例识别； 2 项研究（15.4%）使用客观评估来诊断 GP。只有 4 项研究 (30.8%) 使用非专业社区数据库；其余 9 项研究使用住院、急诊或特定疾病数据库。