Quality of Life Measures Do Not Correlate with Gastric Emptying Scintigraphy

Abstract

Purpose: Gastric empting scintigraphy (GET) of a solid-phase meal is considered the gold standard for the diagnosis of gastroparesis (Amer Gastro Assoc Clin Practice Committee, 2004). Health- related quality of life (QOL) outcome measures encompass the emotional and social dimensions of a patient's illness and physical condition. The Short Form Nepean Dyspepsia Index (SF-NDI) is a 10-item questionnaire focusing on the impact upper GI symptoms have on a person's quality of life. It has been validated in the study of patients with functional dyspepsia. The Dyspepsia Symptom Index (DSI) measures the severity of upper GI symptoms. The aims of our study is 1) correlate GET with quality of life 2) correlate various QOL measures with one another 3) compare QOL measures in patients with normal vs. delayed GET. Methods: 114 patients (F = 75, age 42 ± 13.1, delayed GET = 66) with symptoms of nausea and vomiting for greater than six months had GET to measure 4 hour retention. QOL was assessed by the SF-36 composed of the Physical Composite Score (SF-36 PCS) and Mental Composite Score (SF-36 MCS), SF-NDI, and DSI. The correlation coefficients of GET with the SF-36 PCS, SF-36 MCS, SF-36 total, SF-NDI, and DSI were calculated. In addition, the correlation of the QOL measures with one another were also assessed. Patients were then grouped by GET [normal vs. impaired (4hr GET>10%)]. QOL measures were compared in these 2 groups. Results: 4 hour GET did not correlate with the SF-36 total (r =−0.10, p= 0.29), SF-NDI (r =−0.13, p= 0.18) and DSI (r =−0.05, p= 0.58). There was a correlation between the quality of life measures: SF-36 total and SF-NDI (r =−0.64, p < 0.001), SF-36 total and DSI (r =−0.42, p < 0.001), SF-NDI and DSI (r = 0.46, p < 0.001). When comparing patients with delayed GET vs. normal GET, there were no differences in SF-36 PCS (32.2 ± 1.53 vs. 31.2 ± 1.53, p= 0.66), SF36 MCS (34.6 ± 1.72, vs. 37.8 ± 1.61, p= 0.22), SF-36 total (66.8 ± 2.23 vs. 69.0 ± 2.51, p= 0.52), SF-NDI (38.8 ± 1.23 vs. 36.3 ± 1.42, p= 0.20) and DSI (13.2 ± 0.69 vs. 13.0 ± 0.85, p= 0.81). Conclusions: 1)There is no correlation between gastric emptying and the quality of life measures. 2)There is a correlation between the measures; therefore, it is possible to use the shorter and easier to administer QOL measure (SF-NDI or DSI) to follow patients with gastroparesis. 3)Patients with delayed gastric emptying do not have greater impairment in QOL than those who are symptomatic with a normal GET.