Gastroesophageal reflux disease as a cause of death: analysis of fatal cases under conservative treatment.
BACKGROUND
Treatment of gastroesophageal reflux disease (GERD) with modern acid-suppressive agents is supposed to be effective and safe. However, there have been only a few studies on the mortality in GERD today. In the 1960s the mortality was 0.10-0.17/100,000 per year.


METHODS
From 1990 to 1995, according to Statistics Finland, 78 official death certificates were issued in which GERD was stated to have been the immediate or a primary cause of death.


RESULTS
On completion of analysis data on 52 patients were included in the study. The annual death rate was 0.20/100,000. The causes were hemorrhagic reflux esophagitis in 51.9%, aspiration pneumonia in 34.6%, perforation of esophageal ulcer in 9.6%, and spontaneous esophageal rupture with reflux esophagitis in 3.9%. Thirty-eight patients had been treated with omeprazole or an H2 antagonist, and 44 patients (85%) had severe concomitant disease.


CONCLUSIONS
The mortality in conservatively treated GERD has not decreased. Patients with mental disorder, heart disease, or alcoholism constitute the group in which risk of death from conservatively treated GERD is likely to be greatest.
Rantanen
T K
TK
Dept. of Surgery, Helsinki University Central Hospital, Finland.
Salo
J A
JA
D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002423:Cause of Death; D004942:Esophagitis, Peptic / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000401:mortality*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000627:therapeutic use; D011015:Pneumonia, Aspiration / Q000401:mortality
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists; D009853:Omeprazole