Table 1.
Characteristics of gastroparesis patients by early satiety severity
| Characteristic | Not able to finish a normal size meal score
|
Total (n=198) | p-value* | ||
|---|---|---|---|---|---|
| None/Very mild/Mild (n=53) | Moderate (n=46) | Severe/Very Severe (n=99) | |||
| Etiology | 0.49 | ||||
| Idiopathic | 34 (64.2%) | 31 (67.4%) | 69 (69.7%) | 134 (67.7%) | |
| Diabetic | 19 (35.9%) | 15 (32.6%) | 30 (30.3%) | 64 (32.3%) | |
| Type 1 | 11 (57.9%) | 9 (60.0%) | 19 (63.3%) | 39 (60.9%) | 0.70 |
| Type 2 | 8 (42.1%) | 6 (40.0%) | 11 (36.7%) | 25 (39.1%) | |
| Demographics | |||||
| Gender: females | 44 (83.0%) | 41 (89.1%) | 84 (84.9%) | 169 (85.4%) | 0.86 |
| Age (years) | 47.7 ± 13.8 | 43.6 ± 13.2 | 42.2 ± 12.3 | 44.0 ± 13.1 | 0.02 |
| Hispanic | 9 (17.0%) | 10 (21.7%) | 11 (11.1%) | 30 (15.2%) | 0.24 |
| Race: white | 49 (92.5%) | 41 (89.1%) | 87 (87.9%) | 177 (89.4%) | 0.39 |
| Gastroparesis history | |||||
| Nature of gastroparesis symptoms: | 0.54 | ||||
| Chronic, but stable | 11 (20.8%) | 13 (28.3%) | 10 (10.2%) | 34 (17.3%) | |
| Chronic, but progressive worsening | 4 (7.6%) | 6 (13.0%) | 28 (28.6%) | 38 (19.3%) | |
| Chronic, but some improvement | 7 (13.2%) | 6 (13.0%) | 9 (9.2%) | 22 (11.2%) | |
| Chronic with periodic exacerbations | 17 (32.1%) | 14 (30.4%) | 35 (35.7%) | 66 (33.5%) | |
| Cyclic pattern | 12 (22.6%) | 7 (15.2%) | 16 (16.3%) | 35 (17.8%) | |
| Asymptomatic | 2 (3.8%) | 0 (0.0%) | 0 (0.0%) | 2 (1.0%) | |
| Gastroparesis severity: | <0.0001 | ||||
| Mild (grade 1) | 20 (37.7%) | 8 (17.4%) | 10 (10.2%) | 38 (19.3%) | |
| Compensated (grade 2) | 29 (54.7%) | 34 (73.9%) | 70 (71.4%) | 133 (67.5%) | |
| Gastric failure (grade 3) | 4 (7.6%) | 4 (8.7%) | 18 (18.4%) | 26 (13.2%) | |
| Medical history | |||||
| BMI (kg/m2) | 29.2 ± 8.0 | 28.1 ± 6.1 | 26.1 ± 7.1 | 27.4 ± 7.2 | 0.009 |
| Weight change (kg) from start of gastroparesis | 0.9 ± 31.3 | 4.7 ± 37.7 | −3.3 ± 32.1 | −0.3 ± 33.3 | 0.64 |
| Weight change from start of gastroparesis | 0.77 | ||||
| Increased | 22 (41.5%) | 29 (63.0%) | 42 (42.4%) | 93 (47.0%) | |
| Decreased | 30 (56.6%) | 14 (30.4%) | 54 (54.6%) | 98 (49.5%) | |
| Same | 1 (1.9%) | 3 (6.5%) | 3 (3.0%) | 7 (3.5%) | |
| Weight change in last 6 months | 0.47 | ||||
| Increased | 20 (37.7%) | 17 (37.0%) | 28 (28.3%) | 65 (32.8%) | |
| Decreased | 20 (37.7%) | 19 (41.3%) | 48 (48.5%) | 87 (43.9%) | |
| Same | 13 (24.5%) | 10 (21.7%) | 23 (23.2%) | 46 (23.2%) | |
| Use of prokinetics | 16 (30.2%) | 14 (30.4%) | 36 (36.4%) | 66 (33.3%) | 0.41 |
| Use of antiemetics | 44 (83.0%) | 36 (78.3%) | 79 (79.8%) | 159 (80.3%) | 0.68 |
| Use of narcotics | 19 (35.9%) | 16 (34.8%) | 36 (36.4%) | 71 (35.9%) | 0.93 |
| Laboratory results | |||||
| HbA1c, if diabetic (%) | 8.6 ± 1.9 | 7.7 ± 2.0 | 8.6 ± 1.9 | 8.4 ± 1.9 | 0.80 |
| HbA1c≥8.0%, if diabetic | 11 (57.9%) | 6 (40.0%) | 18 (60.0%) | 33 (55.0%) | 0.77 |
| ANA negative, if idiopathic | 26 (76.5%) | 27 (87.1%) | 62 (89.9%) | 115 (85.8%) | 0.08 |
| ESR, if idiopathic | 14.0 ± 11.1 | 17.0 ± 12.1 | 13.5 ± 12.0 | 14.5 ± 11.8 | 0.46 |
| ESR elevated>30mm, if idiopathic | 4 (11.8%) | 4 (12.9%) | 6 (9.0%) | 14 (10.6%) | 0.61 |
| PAGI-SYM symptom severity (0–5)¶ | |||||
| Nausea/vomiting sub-score | 1.3 ± 1.3 | 1.6 ± 1.3 | 2.3 ± 1.3 | 1.9 ± 1.4 | <0.001 |
| Satiety/fullness sub-score | 1.8 ± 1.0 | 3.0 ± 0.6 | 4.2 ± 0.6 | 3.3 ± 1.2 | <0.001 |
| Stomach fullness score | 2.4 ± 1.3 | 3.3 ± 1.1 | 4.1 ± 0.8 | 3.5 ± 1.3 | <0.001 |
| Not able to finish a normal-sized meal score | 1.2 ± 0.8 | 3.0 ± 0.0 | 4.6 ± 0.5 | 3.3 ± 1.6 | <0.001 |
| Feeling excessively full after meals score | 2.2 ± 1.4 | 3.5 ± 0.9 | 4.5 ± 0.6 | 3.6 ± 1.4 | <0.001 |
| Loss of appetite score | 1.4 ± 1.4 | 2.4 ± 1.2 | 3.6 ± 1.3 | 2.7 ± 1.6 | <0.001 |
| Bloating sub-sore | 1.8 ± 1.5 | 2.9 ± 1.5 | 3.7 ± 1.4 | 3.0 ± 1.7 | <0.001 |
| Cardinal symptom index (GCSI) | 1.6 ± 0.9 | 2.5 ± 0.9 | 3.4 ± 0.7 | 2.7 ± 1.1 | <0.001 |
| Upper abdominal pain sub-score | 2.0 ± 1.6 | 2.5 ± 1.3 | 3.4 ± 1.3 | 2.8 ± 1.5 | <0.001 |
| GERD sub-score | 1.3 ± 1.3 | 2.0 ± 1.4 | 2.0 ± 1.4 | 1.8 ± 1.4 | 0.006 |
| Constipation score | 1.7 ± 1.7 | 2.6 ± 1.8 | 3.1 ± 1.7 | 2.6 ± 1.8 | <0.001 |
| PAGI-QOL (0–5) § | |||||
| Activity sub-score | 3.0 ± 1.2 | 2.9 ± 1.1 | 2.4 ± 1.2 | 2.7 ± 1.2 | 0.001 |
| Clothing sub-score | 3.4 ± 1.6 | 2.9 ± 1.7 | 2.7 ± 1.8 | 2.9 ± 1.8 | 0.02 |
| Diet sub-score | 2.3 ± 1.6 | 2.0 ± 1.2 | 1.4 ± 1.1 | 1.8 ± 1.3 | <0.001 |
| Relationship sub-score | 3.5 ± 1.4 | 3.2 ± 1.4 | 3.2 ± 1.3 | 3.3 ± 1.3 | 0.16 |
| Psychology sub-score | 3.1 ± 1.4 | 3.1 ± 1.4 | 3.1 ± 1.4 | 3.1 ± 1.4 | 0.70 |
| Total PAGI-QOL | 3.1 ± 1.2 | 2.8 ± 1.1 | 2.5 ± 1.0 | 2.8 ± 1.1 | 0.005 |
| SF-36v2 Health Survey (past 4 weeks) ‡ | |||||
| Physical health summary measure | 36.6 ± 11.0 | 35.8 ± 10.5 | 30.7 ± 9.5 | 33.5 ± 10.5 | 0.001 |
| Mental health summary measure | 41.5 ± 12.6 | 41.9 ± 13.3 | 41.6 ± 13.8 | 41.6 ± 13.3 | 0.99 |
| PHQ-15 | |||||
| PHQ-15 total score | 13.0 ± 5.2 | 14.9 ± 4.4 | 14.9 ± 4.6 | 14.4 ± 4.8 | 0.04 |
| No/low somatization | 15 (28.3%) | 5 (10.9%) | 15 (15.2%) | 35 (17.7%) | 0.03 |
| Medium somatization | 16 (30.2%) | 19 (41.3%) | 27 (27.3%) | 62 (31.3%) | |
| High somatization | 22 (41.5%) | 22 (47.8%) | 57 (57.6%) | 101 (51.0%) | |
| Solid gastric scintigraphy | |||||
| Percent retention at 1 hour | 83.0 ± 11.6 | 78.9 ± 15.3 | 80.4 ± 12.3 | 80.7 ± 12.9 | 0.22 |
| Percent retention at 2 hours | 65.7 ± 17.6 | 62.4 ± 15.5 | 65.2 ± 17.3 | 64.7 ± 16.9 | 0.96 |
| Percent retention at 4 hours | 26.1 ± 19.2 | 28.8 ± 15.4 | 33.9 ± 21.3 | 30.6 ± 19.7 | 0.01 |
| Liquid gastric scintigraphy | |||||
| Percent retention at 30 minutes | 60.0 ± 14.1 | 62.2 ± 16.9 | 67.0 ± 17.9 | 64.4 ± 17.0 | 0.07 |
| Percent retention at 1 hour | 47.5 ± 15.3 | 48.0 ± 17.9 | 51.6 ± 17.4 | 49.8 ± 17.0 | 0.22 |
| Water load test | |||||
| Total volume of water consumed (mL) | 472 ± 278 | 335 ± 143 | 326 ± 174 | 368 ± 211 | 0.001 |
| Total volume of water consumed if completely full (mL) | 511 ± 309 | 338 ± 132 | 318 ± 182 | 370 ± 225 | 0.001 |
Data are means ± standard deviations or number (percents).
^
Nausea severity is a score from the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM).
*
The significance of difference in binary variables between groups was tested with a Cochran-Armitage trend test, the significance of difference in categorical variables between groups was tested with a Mantel-Haenszel chi-square test, and the significance of difference in continuous variables between groups was tested with a non-parametric Cuzick test for trend. All P values are two-sided.
§
Subscales derived from the Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL). Scales have been recoded so that a higher score reflects a higher QOL.
‡
Scores on the Medical Outcomes Study 36-Item Short-Form Health Survey V2 (SF-36v2) standard recall were normalized to the 1998 U.S. general population with a mean (±SD) of 50±10. A higher score reflects higher QOL or better health outcome.
¶
Subscales derived from the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM). A higher score reflects a greater severity.