135. A COMPARISON OF THE INOUE ASSESSMENT METHODS AND THE HILL GRADING OF THE GASTROESOPHAGEAL JUNCTION IN DIAGNOSING REFLUX SYMPTOM SEVERITY, ESOPHAGITIS, AND GERD AMONG PATIENTS WHO UNDERWENT UPPER GI ENDOSCOPY IN A TERTIARY HEALTHCARE FACILITY

Abstract

Abstract Gastroesophageal reflux disease (GERD) results from failure of the anti-reflux barriers in the gastroesophageal junction. Inoue proposed cardiac opening (CO), sliding hernia (SH), and scope holding time (SHT%) to assess this junction. To compare these Inoue methods and the Hill grade in diagnosis of severe GERD symptoms, moderate–severe esophagitis and GERD. Patients scheduled for gastroscopy off proton pump inhibitors were included. Symptoms were assessed using the GERDQ score. Esophagitis was determined using the modified LA Classification. The gastroesophageal junction was described using the Inoue methods and the Hill grade. The Inoue methods individually and as a composite score were compared to Hill grade. We were unable to reach our target sample size of 91. Only 69 patients were included. In severe GERD symptom diagnosis (GERDQ ≥11), Inoue score (composed of CO and SH with 1 point each) had good performance (AUC 0.87, 95%CI 0.70–1.04). In moderate–severe esophagitis diagnosis (LA grades B-D), SH (AUC 0.73, 95%CI 0.58–0.88) and Inoue score (AUC 0.79, 95%CI 0.64–0.94) had fair performance. In GERD (either GERDQ ≥8 or esophagitis) diagnosis, Inoue score (AUC 0.88, 95%CI 0.80–0.97) and CO (AUC 0.76, 95%CI 0.63–0.89) had fair-good performance. The rest had poor or failed values. Inoue score had fair-good performance in diagnosing severe GERD symptoms, moderate–severe esophagitis and GERD. Sliding hernia had fair performance in diagnosing moderate–severe esophagitis. CO had fair performance in diagnosing GERD. SHT% and Hill grade were poor/failed for all outcomes.