Saudi Journal of Gastroenterology
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ORIGINAL ARTICLE
Year : 2021  |  Volume : 27  |  Issue : 5  |  Page : 309-315

Characteristics of patients who underwent gastric electrical stimulation vs. surgical pyloric interventions for refractory gastroparesis


1 Department of Internal Medicine, Sunrise Hospital and Medical Center, Las Vegas, NV, United States
2 Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, NY, United States
3 Department of Gastroenterology, Georgetown University, Washington, D.C, United States
4 Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
5 Department of Internal Medicine, Xavier University School of Medicine, Oranjestad, Aruba
6 Department of Gastroenterology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
7 Department of Gastroenterology, University of Louisville, KY, United States

Correspondence Address:
Dr. Saad Saleem
3186 S Maryland parkway, Las Vegas, Nevada - 89109
United States
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjg.sjg_673_20

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Background: There has been recent debate comparing the efficacy of gastric electrical stimulation (GES) with pyloric intervention, but medical literature lacks clear indications for when to perform GES or pyloric intervention. This study aims to assess the effect of sociodemographic factors and hospital characteristics on the surgical technique chosen for the treatment of gastroparesis. Methods: Data was extracted from the National Inpatient Sample between the years 2012 and 2014, using any discharge diagnosis of gastroparesis. For comparison of analysis between GES and pyloric surgical intervention, pyloroplasty, endoscopic pyloric dilation, and pyloromyotomy were considered to be pyloric interventions. The study population was divided into two groups, one which received GES and the other receiving pyloric intervention, to compare socioeconomic factors and hospital characteristics. Results: In total, 737,930 hospitalizations had a discharge diagnosis of gastroparesis between 2012 and 2014. On weighted multivariant analysis of patients undergoing GES or pyloric intervention for gastroparesis, being female (odds ratio (OR) 1.49, 95% confidence interval (CI) 1.25–1.78; P < 0.001), being Hispanic (OR 1.75, 95%CI; P < 0.001), being in urban teaching (OR 1.41, 95%CI 1.15–1.72; P < 0.001), and nonteaching hospitals (OR 2.93, 95%CI 2.4–3.58; P < 0.001), early satiety (OR 6.70, 95%CI 1.54–31.25; P = 0.01), and diabetes mellitus (OR 2.14, 95%CI 1.78–2.56; P < 0.001) were each statistically significantly correlated with receiving GES intervention compared to pyloric intervention. Conclusion: The racial difference, payer source, and hospital location affected the surgical intervention (GES or pyloric intervention) that patients with gastroparesis would receive.


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