The Incidence, Prevalence, and Outcomes of Patients With Gastroparesis in Olmsted County, Minnesota, From 1996 to 2006

doi:10.1053/j.gastro.2008.12.047

Gastroenterology

Volume 136, Issue 4, April 2009, Pages 1225-1233

https://doi.org/10.1053/j.gastro.2008.12.047 Get rights and content

Background & Aims

The epidemiology of gastroparesis is unknown. We aimed to determine the incidence, prevalence, and outcome of gastroparesis in the community.

Methods

Using the Rochester Epidemiology Project, a medical records linkage system in Olmsted County, Minnesota, we identified county residents with potential gastroparesis. The complete medical records were reviewed by a gastroenterologist. Three diagnostic definitions were used: (1) definite gastroparesis, delayed gastric emptying by standard scintigraphy and typical symptoms for more than 3 months; (2) probable gastroparesis, typical symptoms and food retention on endoscopy or upper gastrointestinal study; (3) possible gastroparesis, typical symptoms alone or delayed gastric emptying by scintigraphy without gastrointestinal symptoms. Poisson regression was used to assess the association of incidence rates with age, sex, and calendar period.

Results

Among 3604 potential cases of gastroparesis, 83 met diagnostic criteria for definite gastroparesis, 127 definite plus probable gastroparesis, and 222 any of the 3 definitions of gastroparesis. The age-adjusted (to the 2000 US white population) incidence per 100,000 person-years of definite gastroparesis for the years 1996–2006 was 2.4 (95% confidence interval [CI], 1.2–3.8) for men and 9.8 (95% CI, 7.5–12.1) for women. The age-adjusted prevalence of definite gastroparesis per 100,000 persons on January 1, 2007, was 9.6 (95% CI, 1.8–17.4) for men and 37.8 (95% CI, 23.3–52.4) for women. Overall survival was significantly lower than the age- and sex-specific expected survival computed from the Minnesota white population (P < .05).

Conclusions

Gastroparesis is an uncommon condition in the community but is associated with a poor outcome.

Section snippets

Setting

This study was approved by the institutional review boards of the Mayo Foundation and the Olmsted Medical Center.

Olmsted County is approximately 653 square miles and is located in southeastern Minnesota, 90 miles from a major metropolitan center (Minneapolis/St. Paul). The 2000 census population was 124,277 residents, with 24% employed in the health care industry. The urban center of Rochester (2000 population, 85,806) is surrounded by rural countryside. The demographic characteristics very

Case Characteristics

The initial query of the diagnostic index and gastric emptying test database yielded 3604 potential cases. We excluded 241 subjects (6.7%) who refused research authorization. As a quality control check, we reviewed 100 randomly selected medical records from a list of dyspepsia or dyspepsia-related codes in non–Mayo Clinic subjects and did not identify any eligible cases; therefore, all cases with these diagnostic codes (n = 1215) were excluded. We also reviewed the 210 randomly selected medical

Discussion

This population-based epidemiologic study of gastroparesis has determined the incidence and prevalence of gastroparesis, and we observed significantly lower estimates than data based on tertiary hospital settings.⁴ The age- and sex-adjusted incidence of definite gastroparesis ranged from 6.3 to 17.2 cases per 100,000 person-years. Even applying broader criteria for gastroparesis, the incidence and prevalence remained similar, irrespective of the different diagnostic criteria used. Notably, the

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: This article has an accompanying continuing medical education activity on page 1445. Learning Objective: Upon completion of this CME activity, the reader should understand the variety of presentations of gastroparesis and the AGA consensus recommendations on diagnosis and management options.

: Conflict of interest The authors disclose no conflicts.

: Funding This study was partly funded by Medtronic.

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Clinical—Alimentary TractThe Incidence, Prevalence, and Outcomes of Patients With Gastroparesis in Olmsted County, Minnesota, From 1996 to 2006

Background & Aims

Methods

Results

Conclusions

Section snippets

Setting

Case Characteristics

Discussion

Am J Med

Mayo Clin Proc

Gastroenterology

Clin Gastroenterol Hepatol

J Diabetes Complications

Gastroenterology

Gastroenterology

Gastroenterology

Mayo Clin Proc

Asymptomatic gastric retention in diabetics (gastroparesis diabeticorum)

Ann Intern Med

Development and validation of a patient-assessed gastroparesis symptom severity measure: the Gastroparesis Cardinal Symptom Index

Aliment Pharmacol Ther

Functional dyspepsia, delayed gastric emptying, and impaired quality of life

Gut

Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis

Dig Dis Sci

Gastroparesis-related hospitalizations in the United States: trends, characteristics, and outcomes, 1995–2004

Am J Gastroenterol

Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults

Arch Intern Med

Clinical—Alimentary Tract
The Incidence, Prevalence, and Outcomes of Patients With Gastroparesis in Olmsted County, Minnesota, From 1996 to 2006