Epidemiology, Etiology, and Treatment of Gastroparesis: Real-World Evidence From a Large US National Claims Database

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 162; no. 1; pp. 109 - 121.e5
• Main Authors: Ye, Yizhou, Yin, Yu, Huh, Susanna Y., Almansa, Cristina, Bennett, Dimitri, Camilleri, Michael
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2022
• Subjects: Administrative Claims, Healthcare; Adolescent; Adult; Age Factors; Aged; Comorbidity; Cross-Sectional Studies; Databases, Factual; Etiology; Female; Gastric Emptying; Gastroparesis - diagnosis; Gastroparesis - epidemiology; Gastroparesis - physiopathology; Gastroparesis - therapy; Humans; Male; Middle Aged; Motility Disorders; Observational Study; Population-based; Predictive Value of Tests; Prevalence; Retrospective Studies; Risk Assessment; Risk Factors; Sex Factors; Time Factors; Treatment Outcome; United States; Young Adult; United States; CPRD; Prevalence; Motility Disorders; CI; EMR; ICD; CDM; SD; Population-based; GES; Etiology; REP; Observational Study
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1053/j.gastro.2021.09.064

Although gastroparesis carries a considerable health care and patient burden, associated epidemiological data are limited. To provide new real-world evidence for gastroparesis, we estimated disease prevalence, and investigated patient demographics and disease etiology in a large US claims database. This retrospective, cross-sectional analysis used de-identified, longitudinal patient-level enrollment and billing data for adults from the Optum Clinformatics Data Mart database, a large US national administrative health insurance claims database. Prevalence was age-, sex-, and geographical region–standardized using the 2018 US census. Descriptive analyses of demographic and clinical variables and underlying disease etiologies were performed. The overall standardized prevalence of gastroparesis was 267.7 (95% confidence interval [CI] 264.8–270.7) per 100,000 US adults, whereas prevalence of “definite” gastroparesis (individuals diagnosed within 3 months of gastric emptying scintigraphy testing with persistent symptoms for more than 3 months) was 21.5 (95% CI 20.6–22.4) per 100,000 persons. Patients with gastroparesis had an overall Charlson Comorbidity Index score of 4.2, indicating substantial comorbidity burden. The most frequently documented comorbidities were chronic pulmonary disease (46.4%), diabetes with chronic complication (37.3%), and peripheral vascular disease (30.4%). Patients most commonly had a diabetic etiology (57.4%; type 1, 5.7% and type 2, 51.7%), followed by postsurgical (15.0%), drug-induced (11.8%), and idiopathic (11.3%) etiologies. New evidence is provided regarding the prevalence, patient demographics, and etiology of gastroparesis in the US general population. Wider availability of reliable objective gastric emptying measures and further education of medical professionals in recognizing and diagnosing gastroparesis would benefit future studies and improve understanding of disease epidemiology. [Display omitted] In 100,000 US adults, 267.7 have gastroparesis (falling to 21.5 when using a strict disease definition). Causes of gastroparesis include diabetes (57.4%), surgery (15.0%), medication (11.8%), and unknown/uncertain reasons (11.3%).