Logo image
Back
Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries
Journal article   Open access   Peer reviewed

Effectiveness of gastric electrical stimulation in gastroparesis: Results from a large prospectively collected database of national gastroparesis registries

Thomas L Abell, Goro Yamada, Richard W McCallum, Mark L Van Natta, James Tonascia, Henry P Parkman, Kenneth L Koch, Irene Sarosiek, Gianrico Farrugia, Madhusudan Grover, …
Neurogastroenterology and motility, v 31(12), e13714
Dec 2019
DOI: https://doi.org/10.1111/nmo.13714
PMID: 31584238
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://hdl.handle.net/2027.42/152657View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open
url
https://doi.org/10.1111/nmo.13714View
Published, Version of Record (VoR) Open

Abstract

Adolescent Adult Aged Databases, Factual - statistics & numerical data Diabetic Neuropathies - physiopathology Diabetic Neuropathies - therapy Electric Stimulation Therapy - instrumentation Electric Stimulation Therapy - methods Electrodes, Implanted Female Gastric Emptying Gastroparesis - etiology Gastroparesis - physiopathology Gastroparesis - therapy Humans Male Middle Aged Nausea - etiology Nausea - prevention & control Observational Studies as Topic - statistics & numerical data Propensity Score Retrospective Studies Severity of Illness Index Treatment Outcome Vomiting - etiology Vomiting - prevention & control Young Adult Registries
Gastric electrical stimulation (GES) for treating gastroparesis symptoms is controversial. We studied 319 idiopathic or diabetic gastroparesis symptom patients from the Gastroparesis Clinical Research Consortium (GpCRC) observational studies: 238 without GES and 81 with GES. We assessed the effects of GES using change in GCSI total score and nausea/vomiting subscales between baseline and 48 weeks. We used propensity score methods to control for imbalances in patient characteristics between comparison groups. GES patients were clinically worse (40% severe vs. 18% for non-GES; P < .001); worse PAGI-QOL (2.2. vs. 2.6; P = .003); and worse GCSI total scores (3.5 vs. 2.8; P < .001). We observed improvements in 48-week GCSI total scores for GES vs. non-GES: improvement by ≥ 1-point (RR = 1.63; 95% CI = (1.14, 2.33); P = .01) and change from enrollment (difference = -0.5 (-0.8, -0.3); P < .001). When adjusting for patient characteristics, symptom scores were smaller and not statistically significant: improvement by ≥ 1-point (RR = 1.29 (0.88, 1.90); P = .20) and change from the enrollment (difference = -0.3 (-0.6, 0.0); P = .07). Of the individual items, the nausea improved by ≥ 1 point (RR = 1.31 (1.03, 1.67); P = .04). Patients with GCSI score ≥ 3.0 tended to improve more than those with score < 3.0. (Adjusted P = 0.02). This multicenter study of gastroparesis patients found significant improvements in gastroparesis symptoms among GES patients. Accounting for imbalances in patient characteristics, only nausea remained significant. Patients with greater symptoms at baseline improved more after GES. A much larger sample of patients is needed to fully evaluate symptomatic responses and to identify patients likely to respond to GES.

Metrics

16 Record Views
40 citations in Web of Science
44 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Gastroenterology & Hepatology
Neurosciences
Logo image