Waseem Amjad, MD1, Mirrah Mumtaz, MD1, Adnan Malik, MD2, Ritu Singh, MD3, Asha Pandu, MD, MCPS1, Asra Batool, MD1 1Albany Medical Center, Albany, NY; 2Loyola University Medical Center, Maywood, IL; 3Indiana University Medical Center, Fort Wayne, IN
Introduction: Gastroparesis is a debilitating disorder which includes several upper abdominal symptoms and documented slow gastric emptying (AJG 2013; 108:18). Our aim is to determine the predictors of severe gastroparesis and outcomes of these patients.
Methods: We performed retrospective review of the patients diagnosed with diabetic gastroparesis between September 30th, 2009 and January 31st, 2020. The 99mTc sulfur labeled food was used to diagnose gastroparesis. The severe gastroparesis was defined as gastric retention of >35% of test meal after 240 minutes for solids and 60 minutes for liquids (NEJM 2007; 356:8). Multivariate analysis after adjusting for confounding variables was done to compute the association of severe gastroparesis predictors.
Results: There were 320 patients (mean age 47.5 ± 16.4 years, 70% female, 71.3% white, 39.7% diabetes mellitus) with gastroparesis. Of them, 115 (35.94%) had severe gastroparesis. Multivariate analysis showed that advanced age (OR: 1.02, 95% CI 1.00-1.04, p=0.01), type 1 diabetes mellitus (OR: 3.19, 95% CI 1.36- 7.47) and type 2 diabetes mellitus (OR: 1.85, 95% CI 0.98-3.52, p=0.05) were associated with severe gastroparesis. The obesity (OR: 2.7, 95% CI 0.72-10.15, p=0.06) was modestly associated with severe disease in non-diabetics. The patients with severe gastroparesis had higher refractory disease at 12 weeks of diagnosis (OR: 2.51, 95% CI 1.43-4.40, p=0.001), protein-calorie malnutrition (OR: 2.07, 95% CI 1.06-4.03, p=0.03), and mortality (OR: 2.39, 95% CI 1.03-5.55, p=0.04).
Discussion: Advanced age and diabetes mellitus (type 1 and 2) were associated with objectively severe gastroparesis. The severe gastroparesis was associated with higher mortality, protein-calorie malnutrition, and refractory disease.
Figure: Forest plot showing predictors of severe gastroparesis.
Waseem Amjad indicated no relevant financial relationships.
Mirrah Mumtaz indicated no relevant financial relationships.
Adnan Malik indicated no relevant financial relationships.
Ritu Singh indicated no relevant financial relationships.
Asha Pandu indicated no relevant financial relationships.
Asra Batool indicated no relevant financial relationships.
Waseem Amjad, MD1, Mirrah Mumtaz, MD1, Adnan Malik, MD2, Ritu Singh, MD3, Asha Pandu, MD, MCPS1, Asra Batool, MD1. P0989 - Severe Gastroparesis: The Outcomes and Predictors, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.