Document Detail

Risk factors for erosive esophagitis: a multivariate analysis based on the ProGERD study initiative.
MedLine Citation:
PMID:  15330897     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Gastroesophageal reflux disease can be divided into three categories: nonerosive GERD (NERD), erosive GERD (ERD), and Barrett's esophagus. A shift among these categories rarely occurs. The aim of the present study was to elucidate potential patient-associated risk factors associated with ERD. METHODS: A total of 6,215 patients with troublesome heartburn were recruited to a large, prospective, multicenter open cohort study comprising an initial treatment phase and a 5-yr follow-up phase. Each center planned to recruit an equal number of patients with NERD and ERD. All patients underwent an interview based on standardized questionnaires, a physical examination, and endoscopy with biopsies. Data were analyzed by multiple logistic regression analysis. RESULTS: Risk factor analysis was performed on 5,289 patients (NERD: n = 2,834; ERD: n = 2,455), which was the intent-to-treat population excluding patients with suspected/proven complicated reflux disease. Stepwise regression analysis identified the following independent predictors of ERD: male gender, overweight, regular use of alcohol, a history of GERD >1 yr, and smoker or ex-smoker. A higher level of education and a positive Helicobacter pylori (H. pylori) status were associated with a lower risk of ERD. CONCLUSIONS: Some patient-associated factors increase the risk of erosive esophagitis as opposed to nonerosive reflux disease. However, no single factor or combination of factors is capable of predicting mucosal damage with clinically sufficient certainty. Thus, endoscopy is still required in all GERD patients if valid information on the state of the esophageal mucosa is needed.
Joachim Labenz; Daniel Jaspersen; Michael Kulig; Andreas Leodolter; Tore Lind; Wolfgang Meyer-Sabellek; Manfred Stolte; Micheal Vieth; Stefan Willich; Peter Malfertheiner
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  99     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-27     Completed Date:  2004-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1652-6     Citation Subset:  IM    
Department of Medicine, Jung-Stilling Hospital, Wichernstrasse 40, 57074 Siegen, Germany.
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MeSH Terms
Age Distribution
Case-Control Studies
Cohort Studies
Esophagitis, Peptic / diagnosis*,  epidemiology*
Germany / epidemiology
Logistic Models
Middle Aged
Multivariate Analysis
Prospective Studies
Reference Values
Risk Factors
Severity of Illness Index
Sex Distribution
Comment In:
Am J Gastroenterol. 2005 Jul;100(7):1620-1; author reply 1621   [PMID:  15984991 ]

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