title: Outcome of medical and surgical therapy of GERD: predictive role of quality of life scores and instrumental evaluation.
abstract: BACKGROUND
  Aim of this study is to determine whether quality of life (QoL) assessment in association with instrumental evaluation can help to identify factors predictive of outcome both in surgically and medically treated GERD patients.
  
  
  METHODS
  Between January 2005 and June 2010, 301 patients affected with GERD were included in the study. QoL was evaluated by means of GERD-HRQL and SF-36 questionnaires administered before treatment, at 6 months, at 1 year follow-up and at the end of the study. The multivariate analysis was used to detect if variables such as sex, age, heartburn, acid regurgitation, dysphagia, presence of esophagitis, percentage of total time at pH < 4, symptom index score (SI), the SF-36 and HRQL scores before treatment, at 6 months and 1 year could affect the QoL questionnaires scores at the end of the study.
  
  
  RESULTS
  One hundred forty-seven patients were included in the surgical group and 154 in the medical group. No differences with regard to gender, age, mean SF-36 and HRQL scores before treatment were documented. At the end of the study, quality of life was significantly improved for SF-36 and HRQL scores, either for surgical or medical group. The multivariate analysis showed no factors individually affected the SF-36 and the HRQL scores, but symptom index score (SI) and QoL questionnaires scores at 6 months and 1 year follow-up.
  
  
  CONCLUSIONS
  The combined use of pHmetry with evaluation of SI and QoL questionnaires can predict the outcome of GERD patients managed either by medical or surgical therapy.
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: gianlucarossetti@yahoo.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rossetti
authors.affiliation: Division of General and Bariatric Surgery, School of Medicine, Second University of Naples, Italy. Electronic address: limpao@libero.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: drmarcocimmino@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Cimmino
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: dom.napoletano@gmail.com.
authors.forename: Domenico
authors.initials: D
authors.lastname: Napoletano
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: mariachiarabondanese@libero.it.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Bondanese
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: giovanniromano14@virgilio.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Romano
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: pratilasmanos@hotmail.com.
authors.forename: Manousos
authors.initials: M
authors.lastname: Pratilas
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: ludovica.guerriero@gmail.com.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Guerriero
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: francesco.orlando1@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orlando
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: giovanni.conzo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Italy. Electronic address: bruno.amato@unina.it.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Division of General and Bariatric Surgery, School of Medicine, Second University of Naples, Italy. Electronic address: giovanni.docimo@unina2.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.affiliation: Division of General and Bariatric Surgery, School of Medicine, Second University of Naples, Italy. Electronic address: salvatore.tolone@tin.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Division of General and Bariatric Surgery, School of Medicine, Second University of Naples, Italy. Electronic address: luigibrusciano@tin.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Brusciano
authors.affiliation: Division of General and Bariatric Surgery, School of Medicine, Second University of Naples, Italy. Electronic address: ludovico.docimo@unina2.it.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
authors.affiliation: Department of Anaesthesiological, Surgical and Emergency Sciences, Division of Digestive Surgery, School of Medicine, Second University of Naples, Via Pansini, 5, 80131 Naples, Italy. Electronic address: landino.fei@tin.it.
authors.forename: Landino
authors.initials: L
authors.lastname: Fei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D050782:Esophageal pH Monitoring; D005260:Female; D018662:Fundoplication / Q000379:methods / Q000534:rehabilitation; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011594:Psychometrics; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: GERD; HRQL; Laparoscopic fundoplication; PPI; Quality of life