2009 Southern Regional Meeting Abstracts

Purpose of Study: Gastroparesis (GP), a clinical syndrome associated with nausea/vomiting and disordered gastric emptying, is associated with significant morbidity and mortality. We previously examined a large group of GP patients to see what baseline characteristics might be associated with later mortality and now report on the effect of GES devices on survival.
Methods Used: We examined 441 consecutive patients (81 m, 360 f, mean age 43 years, with Dx: 264 ID, 114DM and 63 post-surgical disorder) with GP symptoms seen over a 15 year period. All patients had the symptoms of nausea, vomiting, early satiety/anorexia, bloating/diarrhea, and/or abdominal pain. Patients were also stratified by the results of a low fat gastric emptying test as delayed or not at 4 hours (>10%). From this data base 430 patients had complete data: 271 patients had been implanted and 159 had been evaluated but not implanted. From the time of evaluation and/or implant, survival at 24 months was compared using a standard Kaplan-Meier survival curve.
Summary of Results: Mean survival was longer for GES implanted patients (23 months) vs controls (21.9 months) , p=0.02. Results for each diagnostic subgroup were similar (p=0.7) but for diabetic patients survival was longer for GES (23.3 months) Vs Control (20.1 months) although this was not statistically significant (p=0.2). Delayed diabetic GES patients also survived longer (23.3 months) than control patients (18.4 months). (See Table 1)
Conclusions: GES devices are associated with significantly improved survival at 24 months Vs control patients. This improvement in survival is especially seen in patients with Diabetic gastroparesis, and especially those with delayed gastric emptying.

Table 1: Survival Among GP Patients (GES Implanted vs. Control)

	Survival	Control Survival	p-value
GES Implanted	23 months	21.9 months	0.02
Diabetic Implanted	23.3 months	20.1 months	0.2
Diabetic Delayed Implanted	23.3 months	18.4 months	>0.5