Clinical Characteristics of Severe Erosive Esophagitis among Patients with Erosive Esophagitis: A Case-control Study.
Objective The risk factors associated with severe erosive esophagitis are not well defined in Japan. We aimed to evaluate the risk factors associated with the endoscopic severity of esophageal mucosal injury. Methods Eighty consecutive Japanese patients with severe erosive esophagitis [Los Angeles (LA) classification grade C or D] who had undergone upper endoscopies in the Gastroenterology Division of Omori Red Cross Hospital between June 2010 and March 2013 were retrospectively analyzed. For each case, a control with mild erosive esophagitis (LA classification grade A or B) who was matched by sex and age was randomly selected during the same period. Among the endoscopic findings, the condition of the gastroesophageal flap valve (GEFV) was graded according to Hill's classification. We identified the risk factors for severe erosive esophagitis using a multivariable logistic regression model. Results A poor performance status (PS) (odds ratio [OR]=17.1201, 95% confidence interval [CI]=3.0268-140.3121, p=0.0008) and an abnormal GEFV (OR=3.0176, 95% CI=1.0589-9.4939, p=0.0385) were risk factors for severe erosive esophagitis, while the presence of open-type gastric mucosal atrophy (GMA) was inversely associated with severe erosive esophagitis (OR=0.2772, 95% CI=0.1087-0.6675, p=0.0040). Conclusion Among patients with erosive esophagitis, a poor PS and an abnormal GEFV were associated while GMA was inversely associated with severe erosive esophagitis. Drug therapy alone or in combination with physical therapy may improve the therapeutic effect on severe erosive esophagitis in patients with a poor PS.
['Ida|Tomonori|T|', 'Inamori|Masahiko|M|', 'Inoh|Yumi|Y|', 'Fujita|Koji|K|', 'Hamanaka|Jun|J|', 'Chiba|Hideyuki|H|', 'Kusakabe|Akihiko|A|', 'Morohashi|Taiki|T|', 'Goto|Toru|T|', 'Maeda|Shin|S|']
D000328:Adult D000368:Aged D016022:Case-Control Studies D004941:Esophagitis D004947:Esophagus D005260:Female D005764:Gastroesophageal Reflux D005773:Gastroscopy D006801:Humans D007564:Japan D016015:Logistic Models D008297:Male D008875:Middle Aged D012189:Retrospective Studies D012307:Risk Factors
severe erosive esophagitis risk factor gastroesophageal flap valve