Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, 90033, USA.
Southern California Clinical and Translational Science Institute (SC-CTSI), Los Angeles, CA, 90033, USA.
Dig Dis Sci. 2021 Jun;66(6):1940-1948. doi: 10.1007/s10620-020-06482-1. Epub 2020 Jul 20.
Defining factors associated with severe reflux esophagitis allows for identification of subgroups most at risk for complications of strictures and esophageal malignancy. We hypothesized there might be unique clinical features in patients with reflux esophagitis in a predominantly Hispanic population of a large, safety-net hospital.
Define clinical and endoscopic features of reflux esophagitis in a predominantly Hispanic population of a large, safety-net hospital.
This is retrospective comparative study of outpatients and hospitalized patients identified with mild (Los Angeles Grade A/B) and severe (Los Angeles Grade C/D) esophagitis through an endoscopy database review. The electronic medical record was reviewed for demographic and clinical data.
Reflux esophagitis was identified in 382/5925 individuals: 56.5% males and 79.8% Hispanic. Multivariable logistic regression model adjusted for age, gender, race, body mass index (BMI), tobacco and alcohol use, and hospitalization status with severity as the outcome showed an interaction between gender and BMI (p ≤ 0.01). Stratification by gender showed that obese females had decreased odds of severe esophagitis compared to normal BMI females (OR = 0.18, 95% CI = 0.07-0.47; p < 0.01). In males, the odds of esophagitis were higher in inpatient status (OR = 2.84, 95% CI = 1.52 - 5.28; p < 0.01) and as age increased (OR = 1.37, 95% CI = 1.03 - 1.83; p = 0.03).
We identify gender-specific associations with severe esophagitis in a predominantly Hispanic cohort. In females, obese BMI appears to be protective against severe esophagitis compared to normal BMI, while in men inpatient status and increasing age were associated with increased odds of severe esophagitis.
明确与严重反流性食管炎相关的因素，可以确定发生狭窄和食管恶性肿瘤并发症风险最高的亚组。我们假设在大型医疗保障医院的以西班牙裔为主的人群中，反流性食管炎患者可能存在独特的临床特征。
明确大型医疗保障医院以西班牙裔为主的人群中，轻度（洛杉矶分级 A/B）和重度（洛杉矶分级 C/D）反流性食管炎患者的临床和内镜特征。
这是一项回顾性对比研究，通过内镜数据库回顾，确定有轻度（洛杉矶分级 A/B）和重度（洛杉矶分级 C/D）食管炎的门诊和住院患者。对电子病历进行了人口统计学和临床数据的回顾。
在 5925 名个体中发现了 382 名反流性食管炎患者：56.5%为男性，79.8%为西班牙裔。多变量逻辑回归模型调整了年龄、性别、种族、体重指数（BMI）、烟草和酒精使用以及住院状态，以严重程度为结果，发现性别和 BMI 之间存在交互作用（p≤0.01）。按性别分层显示，与正常 BMI 的女性相比，肥胖女性发生重度食管炎的几率降低（OR=0.18，95%CI=0.07-0.47；p<0.01）。在男性中，住院状态（OR=2.84，95%CI=1.52-5.28；p<0.01）和年龄增长（OR=1.37，95%CI=1.03-1.83；p=0.03）与食管炎的几率增加相关。
我们在以西班牙裔为主的队列中确定了与重度食管炎相关的性别特异性关联。在女性中，与正常 BMI 相比，肥胖 BMI 似乎可以预防重度食管炎，而在男性中，住院状态和年龄增长与重度食管炎的几率增加相关。
