358 Clinical Features of Reflux Esophagitis in a Predominantly Hispanic Population at a Large Safety-Net Hospital

Abstract

INTRODUCTION: There are many variables whose role remains undefined in predicting esophagitis severity. This is particularly true for female and non-white populations for whom existing data is limited. Our aim was to determine clinical and endoscopic characteristics of reflux esophagitis in the predominantly Hispanic population of a large, safety-net hospital. METHODS: We performed a retrospective electronic medical record review of patients identified with mild (Los Angeles Grade A/B) and severe (Los Angeles Grade C/D) esophagitis between January 2017 to December 2018. Demographic, clinical, and endoscopic data were recorded. Continuous and categorical data was analyzed using a two tailed T-test and/or chi-square test or Fisher’s Exact test. RESULTS: Reflux esophagitis was identified in 382 patients; 56.5% (n = 216) males, 79.8% (n = 305) Hispanic, 8.4% (n = 32) Caucasian, 5.8% (n = 22) African American, and 6.0% (n = 23) other. Among the cohort, 59% (n = 225) had mild esophagitis and 41% (n = 157) had severe esophagitis with median ages 56 and 58 years, respectively (P = 0.05). Patients with mild esophagitis had a higher body mass index (BMI) as compared to those with severe esophagitis [median 28.4 (25.5, 33.7) vs. 26.3 (21.9, 29.6); P < 0.01], were more frequently female (P = 0.03), diagnosed in the outpatient setting vs. inpatient (P < 0.01), and had higher rates of cirrhosis (P = 0.03). Gastroparesis (P = 0.02) and immunosuppression (P = 0.01) were more common in severe vs. mild esophagitis. Hiatal hernia (P < 0.01) and esophageal strictures (P = 0.01) were more frequent in severe esophagitis. Gastrointestinal bleed (P < 0.01), dysphagia (P < 0.01) and nausea/vomiting (P = 0.02) were more frequently the indication for endoscopy in severe vs. mild esophagitis. Esophagitis severity was not associated with tobacco or alcohol use. CONCLUSION: In this predominantly Hispanic cohort, patients with severe esophagitis were more frequently male, hospitalized, and had lower BMI compared to those with mild esophagitis. Ongoing multivariate analysis is underway to determine whether these variables are independent risk factors for severity of esophagitis in this unique population after adjustment for age, BMI, and hospitalization status.