Factors associated with complicated erosive esophagitis: A Japanese multicenter, prospective, cross-sectional study

Table 1 Demographic and clinical characteristics of erosive esophagitis patients with and without complications n (%)

	With complications (n = 143)	Without complications (n = 1606)	P value
Sex (M/F)	74/69	970/636	0.043
Age (years old)	74.4 ± 11.0	67.4 ± 9.2	< 0.001
BMI (kg/m2)	23.2 ± 3.8	23.8 ± 3.5	0.074
General condition (tube-fed/bedridden/tube-fed + bedridden)	0/8/0	1/5/1	< 0.001
Consultation behavior (outpatient/inpatient/emergency patient)	90/26/27	1511/83/12	< 0.001
Smoking (never/current smoker/ex-smoker)	94/16/33	955/234/417	0.311
Duration of smoking cessation (yr)	16.8 ± 13.7	14.5 ± 13.3	0.359
Alcohol drinking			< 0.001
Never	76 (53.1)	711 (44.3)
Current
< 1 d per week	10 (7.0)	199 (12.4)
2-4 d per week	4 (2.8)	192 (12.0)
> 5 d per week	38 (26.6)	432 (26.9)
Ex-drinker	15 (10.5)	72 (4.5)
Duration of drinking cessation (yr)	8.8 ± 9.7	9.0 ± 10.8	0.957
Comorbidities
Hypertension	71 (49.7)	724 (45.1)	0.293
Diabetes mellitus	26 (18.2)	282 (17.6)	0.851
Hyperlipidemia	33 (23.1)	391 (24.3)	0.734
Cerebrovascular disease	22 (15.4)	83 (5.2)	< 0.001
Liver cirrhosis	4 (2.8)	30 (1.9)	0.441
Ischemic cardiac disease	13 (9.1)	85 (5.3)	0.058
Collagen disease	6 (4.2)	34 (2.1)	0.111
Dementia	13 (9.1)	11 (0.7)	< 0.001
Kyphosis	11 (7.7)	36 (2.2)	< 0.001
PPI treatment status			0.001
Never	20 (27.4)	395 (50.4)
Continuation therapy	40 (54.8)	251 (32.1)
On-demand therapy	2 (2.7)	35 (4.5)
Cessation	11(15.1)	102 (13.0)
Concomitant medication
Antithrombogenic	31 (21.7)	216 (13.5)	0.007
Aspirin	12 (8.4)	97 (6.0)	0.265
Antiplatelet agent	15 (10.5)	89 (5.5)	0.017
Anticoagulant agent	8 (5.6)	60 (3.7)	0.271
Antihypertensive drug	58 (40.6)	615 (38.3)	0.594
NSAID	17 (11.9)	91 (5.7)	0.003
Psychotropic	16 (11.2)	40 (2.5)	< 0.001

BMI: Body mass index; PPI: Proton pump inhibitor; NSAID: Nonsteroidal antiinflammatory drug.

Table 2 Symptoms at the time of endoscopy of erosive esophagitis patients with and without complications n (%)

	With complications (n = 143)	Without complications (n = 1606)	P value
Upper GI symptoms
Heartburn	86 (60.1)	773 (48.1)	0.006
Regurgitation	54 (37.8)	428 (26.7)	0.004
Epigastric pain	34 (23.8)	261 (16.3)	0.022
Epigastric burning	28 (19.6)	149 (9.3)	< 0.001
Heavy stomach feeling	42 (29.4)	398 (24.8)	0.227
Early satiety	19 (13.3)	136 (8.5)	0.052
Lower GI symptoms
Abdominal Bloating	10 (7.0)	165 (10.3)	0.210
Constipation	39 (27.3)	277 (17.2)	0.003
Diarrhea	7 (4.9)	117 (7.3)	0.286
Constipation/diarrhea	5 (3.5)	39 (2.4)	0.434

GI: Gastrointestinal.

Table 3 Endoscopic findings of erosive esophagitis patients with and without complications n (%)

	With complications (n = 143)	Without complications (n = 1606)	P value
Los Angeles classification			< 0.001
A	19 (13.3)	976 (60.8)
B	30 (21.0)	478 (29.8)
C	43 (30.1)	119 (7.4)
D	51 (35.7)	33 (2.1)
Gastric mucosal atrophy	82 (57.3)	930 (57.9)	0.464
Hiatal hernia	123 (86.0)	1070 (66.6)	< 0.001
Barrett’s epithelium	8 (5.6)	24 (1.5)	< 0.001
H. pylori infection			< 0.001
Positive	10 (7.0)	134 (8.3)
Negative	31 (21.7)	677 (42.2)
Unknown	102 (71.3)	795 (49.5)

H. pylori: Helicobacter pylori.

Table 4 Relative risk for complications of erosive esophagitis (multivariable analysis)

	Odds ratio (95%CI)	P value
Ages	1.05 (1.03-1.08)	< 0.001
Alcohol drinking
Never	1.00	-
< 1 d per week	0.73 (0.32-1.52)	0.425
2-4 d per week	0.23 (0.06-0.61)	0.008
> 5 d per week	1.32 (0.80-2.14)	0.268
Concomitant medication: psychotropic agent	6.51 (3.01-13.61)	< 0.001
Los Angeles classification grade
A	1.00	-
B	2.69 (1.48-4.96)	0.001
C	15.38 (8.62-28.37)	< 0.001
D	71.49 (37.47-142.01)	< 0.001