Psychoemotional Factors and Their Influence on the Quality of Life in Patient with GERD
Charles Hill MD 1, Yvonne Versluijs MD 2, Elisa Furay MD 1, Deonna Reese-White 3, Cole Holan 3, Jeremiah Alexander 3, Stephanie Doggett PA 1, David Ring MD, PHD 2, F. P. Buckley MD 1
1. Department of Surgery and Perioperative Care, University of Texas at Austin, Austin, Texas
2. Department of Orthopaedic Surgery, University of Texas at Austin, Austin, Texas
3. Dell Medical School, University of Texas at Austin, Austin, Texas
ABSTRACT
INTRODUCTION: Patient reported outcomes (PROs) are integral to determining the success of foregut surgical interventions and psychoemotional factors have been hypothesized to impact the quality of life of patients. This study evaluates the correlation between PROs--specifically the Gastroesophageal Reflux Disease-Health Related Quality of Life (GERD-HRQL) and the Laryngopharangeal Reflux Symptom Index (LPR-RSI)--and the recently validated Esophageal Hypervigilance Anxiety Scale (EHAS). We hypothesize that patients with higher EHAS scores have significantly elevated GERD-HRQL LPR-RSI compared to those with normal scores. EHAS has been developed and validated in chronic esophageal disorders but clinical impact is unknown.
METHODS: In this retrospective study, 237 patients (39% men, average age 56 ± 16) completed the following surveys; (1) EHAS, (2) GERD-HRQL and (3) LPR-RSI. All patients referred for surgical evaluation of GERD the surveys as part of their preoperative workup and postoperative follow-up
RESULTS: In bivariate analysis, EHAS correlated with both GERD-HRQL (r 0.41, P=<0.001) and LPR-RSI (r 0.24, P=0.009). Accounting for potential confounding with sex and age in multivariable linear regression models, a higher GERD-HRQL score (β 0.31; 95% CI 0.23 to 0.39; P=<0.001; Semipartial R2 0.20) and a higher LPR-RSI score (β 0.15; 95% CI 0.08 to 0.22; P=<0.001; Semipartial R2 0.08) were independently associated with higher EHAS.
CONCLUSION: The observed relationship between mental health and GERD symptom intensity is consistent with the biopsychosocial paradigm of illness. Future studies focused on post-surgical outcomes following the incorporation of EHAS into perioperative care is needed to evaluate its effectiveness as a clinical decision support tool in ARS.
Keywords: GERD, reflux, outcomes, surgery