title: Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis.
abstract: OBJECTIVE
  Gastroparesis is a chronic clinical syndrome characterized by delayed gastric emptying. However, little is known about patient outcomes or factors associated with reduction of symptoms.
  
  
  METHODS
  We studied adult patients with gastroparesis (of diabetic or idiopathic type) enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Gastroparesis Registry, seen every 16 weeks and treated according to the standard of care with prescribed medications or other therapies at 7 tertiary care centers. Characteristics associated with reduced symptoms, based on a decrease of 1 or more in the gastroparesis cardinal symptom index (GCSI) score after 48 weeks of care, were determined from logistic regression models. Data were collected from patients for up to 4 years (median, 2.1 y).
  
  
  RESULTS
  Of 262 patients, 28% had reductions in GCSI scores of 1 or more at 48 weeks. However, there were no significant reductions in GCSI score from weeks 48 through 192. Factors independently associated with reduced symptoms at 48 weeks included male sex, age 50 years and older, initial infectious prodrome, antidepressant use, and 4-hour gastric retention greater than 20%. Factors associated with no reduction in symptoms included overweight or obesity, a history of smoking, use of pain modulators, moderate to severe abdominal pain, a severe gastroesophageal reflex, and moderate to severe depression.
  
  
  CONCLUSIONS
  Over a median follow-up period of 2.1 years, 28% of patients treated for gastroparesis at centers of expertise had reductions in GCSI scores of 1 or greater, regardless of diabetes. These findings indicate the chronic nature of gastroparesis. We identified factors associated with reduced symptoms that might be used to guide treatment. ClinicalTrials.gov no: NCT00398801.
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland. Electronic address: Ppasric1@jhmi.edu.
authors: Pankaj J
authors: PJ
authors: Pasricha
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors: Katherine P
authors: KP
authors: Yates
authors: Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, California.
authors: Linda
authors: L
authors: Nguyen
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors: John
authors: J
authors: Clarke
authors: Division of Gastroenterology, University of Louisville, Louisville, Kentucky.
authors: Thomas L
authors: TL
authors: Abell
authors: Mayo Clinic, Rochester, Minnesota.
authors: Gianrico
authors: G
authors: Farrugia
authors: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.
authors: William L
authors: WL
authors: Hasler
authors: Department of Internal Medicine/Gastroenterology, Wake Forest University, Winston-Salem, North Carolina.
authors: Kenneth L
authors: KL
authors: Koch
authors: Center of Neurogastroenterology and Motility, California Pacific Medical Center, San Francisco, California.
authors: William J
authors: WJ
authors: Snape
authors: Internal Medicine Department, Texas Tech University, El Paso, Texas.
authors: Richard W
authors: RW
authors: McCallum
authors: Internal Medicine Department, Texas Tech University, El Paso, Texas.
authors: Irene
authors: I
authors: Sarosiek
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors: James
authors: J
authors: Tonascia
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors: Laura A
authors: LA
authors: Miriel
authors: Division of Gastroenterology, Johns Hopkins University School of Medicine, and Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.
authors: Linda
authors: L
authors: Lee
authors: Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors: Frank
authors: F
authors: Hamilton
authors: Gastroenterology Section Department of Medicine, Temple University, Philadelphia, Pennsylvania.
authors: Henry P
authors: HP
authors: Parkman
mesh_terms: D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008019:Life Style; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012042:Registries; D012074:Remission Induction; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: Etiology; GpCRC; Improvement; Predictors