title: GORD symptoms in lung transplantation: how efficient is the reflux symptom index questionnaire compared to the esophageal impedance test?
abstract: OBJECTIVE
  As Gastroesophageal reflux disease (GORD) affects long-term survival in lung transplant recipients, the aim of this observational prospective study was to analyze the efficacy of The Reflux Symptom Index Questionnaire (RSI) compared to the esophageal impedance test.
  
  
  METHODS
  Both esophageal impedance studies and RSI questionnaire were routinely performed in all patients who had completed rehabilitation following lung transplantation from June 2013 till March 2014. RSI generates a score of between zero and forty-five, taking into account any symptoms within four wk of the questionnaire. Our analysis considered RSI score cut-offs of 10 and 13 indicating significance of reflux.
  
  
  RESULTS
  Out of 84 patients, 50 (59.5%) had evidence of GORD detected by impedance studies, whereas only 33 (39.2%) and 22 (26.2%) had RSI >10 and 13, respectively. An elevated RSI was not found to be associated with positive impedance studies using a score of either 10 or 13 (p = 0.127 and p = 0.142, respectively); 32.1% (n = 27) and 40.5% (n = 34) were found to have negative RSI and positive impedance test using 10 or 13 as cut-off, respectively.
  
  
  CONCLUSIONS
  RSI Score is an unreliable predictor of GORD among lung transplant recipients. The authors therefore recommend the routine use of impedance testing in post-transplant patients.
authors.affiliation: Department of Lung Failure and Transplant Medicine, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UK.
authors.forename: Simona
authors.initials: S
authors.lastname: Soresi
authors.affiliation: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK.|Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zeriouh
authors.affiliation: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK.|Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Sabashnikov
authors.affiliation: Department of Lung Failure and Transplant Medicine, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UK.
authors.forename: Grainne
authors.initials: G
authors.lastname: Mc Dermott
authors.affiliation: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Weymann
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wippermann
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital Cologne, Cologne, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Wahlers
authors.affiliation: Department of Lung Failure and Transplant Medicine, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Reed
authors.affiliation: Department of Lung Failure and Transplant Medicine, Royal Brompton & Harefield NHS Foundation Trust, Harefield, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Carby
authors.affiliation: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK.
authors.forename: Andre R
authors.initials: AR
authors.lastname: Simon
authors.affiliation: Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Royal Brompton & Harefield NHS Foundation Trust, Harefield Hospital, Harefield, UK.
authors.forename: Aron-Frederik
authors.initials: AF
authors.lastname: Popov
mesh_terms: D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000209:etiology*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000601:surgery*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: esophageal impedance test; gastroesophageal reflux disease; lung transplantation; reflux symptom index score