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The Influence of Race on Symptom Severity and Quality of Life in Gastroparesis

Friedenberg, Frank K. MD, MS (Epi); Kowalczyk, Monika MD; Parkman, Henry P. MD

Journal of Clinical Gastroenterology: October 2013 - Volume 47 - Issue 9 - p 757–761
doi: 10.1097/MCG.0b013e3182819aae
ALIMENTARY TRACT: Original Articles

Background: The majority of clinical studies for gastroparesis have primarily included white women. Our aim was to compare the etiology, clinical characteristics, healthcare utilization, symptom profile, and quality of life (QOL) in white and nonwhite patients with gastroparesis.

Methods: Newly referred patients with gastroparesis completed: (1) a comprehensive demographic profile, (2) the Patient Assessment of Upper Gastrointestinal Disorder Symptoms (PAGI-SYM), and (3) the Patient Assessment of Upper Gastrointestinal Disorders QOL (PAGI-QOL). All patients had confirmed delayed gastric emptying as measured by 4-hour scintigraphy.

Results: A total of 255 patients were enrolled; mean age was 42.5 years and 83.3% were females. There were 44 (17%) nonwhites (33 African American and 11 Hispanic) and 211 (83%) whites. The proportion of nonwhite patients with gastroparesis secondary to diabetes was 55% compared with 19% of white patients (P<0.001). The total PAGI-SYM score was higher in nonwhite patients. Nonwhite patients had higher PAGI-SYM subscale scores for nausea/vomiting, upper abdominal pain, and lower abdominal pain. The 2 groups differed in health care utilization: 49% of nonwhite patients reported ≥4 gastroparesis-related emergency department visits and 42% reported more ≥4 gastroparesis-related hospitalizations, as compared with 20% and 14% of white patients, respectively. Total PAGI-QOL scores were lower in nonwhite patients. Linear regression showed that nonwhite race, sex, age, and age of onset were independently associated with symptom scores, whereas etiology of gastroparesis and gastric emptying times were not.

Conclusions: Nonwhite patients with gastroparesis had more severe symptoms, poorer QOL, and utilized more health care resources than white. Nonwhites were more likely to have diabetes as the etiology.

Department of Medicine, Gastroenterology Section, Temple University School of Medicine, Philadelphia, PA

The authors declare that they have nothing to disclose.

F.K.F.: study concept and design; analysis and interpretation of data; drafting of manuscript, critical revision of the manuscript for important intellectual content; statistical analysis; study supervision. M.K.: study concept and design; acquisition of data; analysis and interpretation of data; drafting of manuscript, critical revision of the manuscript for important intellectual content; statistical analysis. H.P.P.: study concept and design; acquisition of data; analysis and interpretation of data; critical revision of the manuscript for important intellectual content; study supervision.

Reprints: Henry P. Parkman, MD, Department of Medicine, Gastroenterology Section, Temple University School of Medicine, Parkinson Pavilion, 8th Floor, 3401 North Broad Street, Philadelphia, PA 19140 (e-mail: henry.parkman@temple.edu).

Received August 19, 2012

Accepted December 5, 2012

© 2013 by Lippincott Williams & Wilkins