Chronic gastric electrical stimulation for gastroparesis reduces the use of prokinetic and/or antiemetic medications and the need for hospitalizations.
To investigate the effect of chronic gastric electrical stimulation (GES) on the daily use of prokinetics and antiemetics, hospitalizations, total symptom score (TSS), SF-36 status for health-related quality of life (HQOL), and gastric emptying of a solid meal, we evaluated 37 gastroparetic patients preoperatively and 1 year after undergoing GES implant. Prokinetic and antiemetic use was significantly reduced. Of 27 patients on at least one prokinetic at baseline, 8 were off at 1 year. Twenty-six patients requiring antiemetics before surgery decreased to 17. Mean TSS was significantly reduced and the reduction for patients off medications was significantly better than for patients still on medications. Overall SF-36 scores for HQOL were significantly improved, and patients off antiemetics had a significantly higher HQOL score than for patients on antiemetics at 1 year. Hospitalizations decreased from 50 +/- 10 days for the year prior to GES therapy to 14 +/- 3 days (P < 0.05). However, gastric emptying was not significantly improved. Conclusions are as follows. (1) Chronic GES significantly reduced the use of prokinetic/antiemetic medications and the need for hospitalization in gastropraretic patients, whose clinical and quality of life outcomes also significantly improved. (2) These data provide evidence of the positive economic impact of this new therapy on long-term clinical outcomes in gastroparetic patients not responding to standard medical therapy.
Lin
Zhiyue
Z
Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas 66160, USA.
McElhinney
Chris
C
Sarosiek
Irene
I
Forster
Jameson
J
McCallum
Richard
R
D000328:Adult; D000932:Antiemetics / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004599:Electric Stimulation Therapy / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005746:Gastric Emptying; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005769:Gastrointestinal Motility / Q000187:drug effects*; D018589:Gastroparesis / Q000503:physiopathology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D018529:Nutritional Support; D011788:Quality of Life
D000932:Antiemetics; D005765:Gastrointestinal Agents