The population impact of modern treatment on complicated gastroesophageal reflux disease (GERD) is not well understood.
Dr Tuomo Rantanen and colleagues from Finland determined the current mortality from GERD in Finland and compared this with the use of health resources.
The researchers conducted a population-based retrospective study of Finland's administrative databases.
These databases provided figures on the nationwide use of antireflux medication, rate of antireflux surgery, and mortality from GERD.
Any deceased person included had classic symptoms as well as objective findings of GERD.
|Hemorrhagic esophagitis was the cuase of death in 47%|
|American Journal of Gastroenterology|
The researchers analyzed the medical records of 306 patients, and included 213 patients.
The research team found that annual mortality from GERD increased from 0.2 per 100,000 in 1987 to 0.5 per 100,000 in 2000.
During that time, the team noted that the use of H2-blockers, proton pump inhibitors, and the annual rate of antireflux surgery increased.
Mortality from antireflux surgery, including fundoplication and gastric and esophageal resection, remained around 2 per 1000 operations.
Of the 213 patients whose cause of death was considered to be GERD, 180 had received medical treatment.
The team noted that the deaths of 4 patients were related to either diagnostic or therapeutic endoscopy.
The researchers found that early complications of antireflux surgery caused deaths in 22%.
The researchers found that 4% of deaths were late failures of antireflux surgery.
Causes of death in the medical group were hemorrhagic esophagitis in 47%, and aspiration pneumonia in 23%.
The research team found that ulcer perforation was the cause of death in 14%, rupture with esophagitis in 16%, and stricture in 14%.
Dr Rantanen's concludes, “Regardless of the increased use of health resources, mortality from GERD, especially with medical treatment, has risen.”
“Surgery for GERD was also associated with early mortality and usually could not prevent the fatal outcome.”