The Brief Esophageal Dysphagia Questionnaire shows better discriminative capacity for clinical and manometric findings than the Eckardt score: Results from a multicenter study.

Autor: Cisternas D; Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile., Taft T; Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Carlson DA; Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Glasinovic E; Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile., Monrroy H; Pontificia Universidad Católica de Chile, Santiago, Chile., Rey P; Pontificia Universidad Católica de Chile, Santiago, Chile., Hani A; San Ignacio Hospital, Pontificia Universidad Javeriana, Bogota, Colombia., Ardila-Hani A; San Ignacio Hospital, Pontificia Universidad Javeriana, Bogota, Colombia., Leguizamo AM; San Ignacio Hospital, Pontificia Universidad Javeriana, Bogota, Colombia., Bilder C; Hospital Universitario, Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina., Ditaranto A; Hospital Universitario, Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina., Varela A; Hospital Universitario, Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina., Agotegaray J; Hospital Universitario, Escuela de Medicina, Fundación Favaloro, Buenos Aires, Argentina., Remes-Troche JM; Universidad Veracruzana, Veracruz, Mexico., de León AR; Hospital Clínico San Carlos, Universidad Complutense Madrid, Madrid, Spain., de la Serna JP; Hospital Clínico San Carlos, Universidad Complutense Madrid, Madrid, Spain., Marin I; University Hospital Germans Trias i Pujol, Motility and Functional Gut Disorders Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat Autonoma de Barcelona, Badalona, Spain., Serra J; Digestive System Research Unit, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), University Hospital Vall d'Hebron, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society [Neurogastroenterol Motil] 2022 Apr; Vol. 34 (4), pp. e14228. Date of Electronic Publication: 2021 Aug 02.
DOI: 10.1111/nmo.14228
Abstrakt: Introduction: Grading dysphagia is crucial for clinical management of patients. The Eckardt score (ES) is the most commonly used for this purpose. We aimed to compare the ES with the recently developed Brief Esophageal Dysphagia Questionnaire (BEDQ) in terms of their correlation and discriminative capacity for clinical and manometric findings and evaluate the effect of gastroesophageal reflux symptoms on both.
Methods: Symptomatic patients referred for high-resolution manometry (HRM) were prospectively recruited from seven centers in Spain and Latin America. Clinical data and several scores (ES, BEDQ, GERDQ) were collected and contrasted to HRM findings. Standard statistical analysis was performed.
Key Results: 426 patients were recruited, 31.2% and 41.5% being referred exclusively for dysphagia and GERD symptoms, respectively. Both BEDQ and ES were independently associated with achalasia. Only BEDQ was independently associated with being referred for dysphagia and with relevant HRM findings. ROC curve analysis for achalasia diagnosis showed AUC of 0.809 for BEDQ and 0.765 for ES, with the main difference being higher BEDQ sensitivity (80.0% vs 70.8% for ES). GERDQ independently predicted ES but not BEDQ. In the absence of dysphagia (BEDQ = 0), GERD symptoms significantly determine ES.
Conclusions and Inferences: Our study suggests both the BEDQ and ES can complementarily describe symptomatic burden in achalasia. BEDQ has several advantages over the ES in the dysphagia evaluation, basically due to its higher sensitivity for manometric diagnosis and independence of GERD symptoms. ES should be used as an achalasia-specific metric, while BEDQ is a better symptom-generic evaluating tool.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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