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Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea

BACKGROUND/AIMS: Although an association between achalasia and esophageal cancer has been reported, whether achalasia confers a substantial increase in mortality is unknown. Moreover, the causes of death related to achalasia have not been investigated. We performed this nationwide, population-based...

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Autores principales: Kim, Ga Hee, Park, Hyungchul, Jung, Kee Wook, Kim, Min-Ju, Kim, Ye-Jee, Lee, Ji Min, Lee, Bong Eun, Min, Yang Won, Kim, Jeong Hwan, Na, Hee Kyong, Ahn, Ji Yong, Lee, Jeong Hoon, Kim, Do Hoon, Choi, Kee Don, Song, Ho June, Lee, Gin Hyug, Jung, Hwoon-Yong, Kim, Hyun Jin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651379/
https://www.ncbi.nlm.nih.gov/pubmed/36987382
http://dx.doi.org/10.5009/gnl220334
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author Kim, Ga Hee
Park, Hyungchul
Jung, Kee Wook
Kim, Min-Ju
Kim, Ye-Jee
Lee, Ji Min
Lee, Bong Eun
Min, Yang Won
Kim, Jeong Hwan
Na, Hee Kyong
Ahn, Ji Yong
Lee, Jeong Hoon
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jung, Hwoon-Yong
Kim, Hyun Jin
author_facet Kim, Ga Hee
Park, Hyungchul
Jung, Kee Wook
Kim, Min-Ju
Kim, Ye-Jee
Lee, Ji Min
Lee, Bong Eun
Min, Yang Won
Kim, Jeong Hwan
Na, Hee Kyong
Ahn, Ji Yong
Lee, Jeong Hoon
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jung, Hwoon-Yong
Kim, Hyun Jin
author_sort Kim, Ga Hee
collection PubMed
description BACKGROUND/AIMS: Although an association between achalasia and esophageal cancer has been reported, whether achalasia confers a substantial increase in mortality is unknown. Moreover, the causes of death related to achalasia have not been investigated. We performed this nationwide, population-based cohort study on achalasia because no such study has been performed since the introduction of high-resolution manometry in 2008. METHODS: This study was performed using data extracted from the Korean National Health Insurance Service database, covering a 9-year period from 2009 to 2017. Control participants without a diagnostic code for achalasia were randomly selected and matched by sex and birth year at a case-to-control ratio of 14. Data on the cause of death from Statistics Korea were also analyzed. RESULTS: The overall incidence of achalasia was 0.68 per 100,000 person-years, and the prevalence was 6.46 per 100,000 population. Patients with achalasia (n=3,063) had significantly higher adjusted hazard ratio (aHR) for esophageal cancer (aHR, 3.40; 95% confidence interval [CI], 1.25 to 9.22; p=0.017), pneumonia (aHR, 2.30; 95% CI, 1.89 to 2.81; p<0.001), aspiration pneumonia (aHR, 3.92; 95% CI, 2.38 to 6.48; p<0.001), and mortality (aHR, 1.68; 95% CI, 1.44 to 1.94; p<0.001). Esophageal cancer carried the highest mortality risk (aHR, 8.82; 95% CI, 2.35 to 33.16; p=0.001), while pneumonia had the highest non-cancer mortality risk (aHR, 2.28; 95% CI, 1.31 to 3.96; p=0.004). CONCLUSIONS: In this nationwide study, achalasia was associated with increased risk of mortality. Esophageal cancer and pneumonia were the most common comorbidities and the major causes of death in patients with achalasia.
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spelling pubmed-106513792023-03-29 Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea Kim, Ga Hee Park, Hyungchul Jung, Kee Wook Kim, Min-Ju Kim, Ye-Jee Lee, Ji Min Lee, Bong Eun Min, Yang Won Kim, Jeong Hwan Na, Hee Kyong Ahn, Ji Yong Lee, Jeong Hoon Kim, Do Hoon Choi, Kee Don Song, Ho June Lee, Gin Hyug Jung, Hwoon-Yong Kim, Hyun Jin Gut Liver Original Article BACKGROUND/AIMS: Although an association between achalasia and esophageal cancer has been reported, whether achalasia confers a substantial increase in mortality is unknown. Moreover, the causes of death related to achalasia have not been investigated. We performed this nationwide, population-based cohort study on achalasia because no such study has been performed since the introduction of high-resolution manometry in 2008. METHODS: This study was performed using data extracted from the Korean National Health Insurance Service database, covering a 9-year period from 2009 to 2017. Control participants without a diagnostic code for achalasia were randomly selected and matched by sex and birth year at a case-to-control ratio of 14. Data on the cause of death from Statistics Korea were also analyzed. RESULTS: The overall incidence of achalasia was 0.68 per 100,000 person-years, and the prevalence was 6.46 per 100,000 population. Patients with achalasia (n=3,063) had significantly higher adjusted hazard ratio (aHR) for esophageal cancer (aHR, 3.40; 95% confidence interval [CI], 1.25 to 9.22; p=0.017), pneumonia (aHR, 2.30; 95% CI, 1.89 to 2.81; p<0.001), aspiration pneumonia (aHR, 3.92; 95% CI, 2.38 to 6.48; p<0.001), and mortality (aHR, 1.68; 95% CI, 1.44 to 1.94; p<0.001). Esophageal cancer carried the highest mortality risk (aHR, 8.82; 95% CI, 2.35 to 33.16; p=0.001), while pneumonia had the highest non-cancer mortality risk (aHR, 2.28; 95% CI, 1.31 to 3.96; p=0.004). CONCLUSIONS: In this nationwide study, achalasia was associated with increased risk of mortality. Esophageal cancer and pneumonia were the most common comorbidities and the major causes of death in patients with achalasia. Editorial Office of Gut and Liver 2023-11-15 2023-03-29 /pmc/articles/PMC10651379/ /pubmed/36987382 http://dx.doi.org/10.5009/gnl220334 Text en Copyright © Gut and Liver. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Ga Hee
Park, Hyungchul
Jung, Kee Wook
Kim, Min-Ju
Kim, Ye-Jee
Lee, Ji Min
Lee, Bong Eun
Min, Yang Won
Kim, Jeong Hwan
Na, Hee Kyong
Ahn, Ji Yong
Lee, Jeong Hoon
Kim, Do Hoon
Choi, Kee Don
Song, Ho June
Lee, Gin Hyug
Jung, Hwoon-Yong
Kim, Hyun Jin
Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title_full Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title_fullStr Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title_full_unstemmed Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title_short Incidence, Morbidity, and Mortality of Achalasia: A Nationwide, Population-Based Cohort Study in South Korea
title_sort incidence, morbidity, and mortality of achalasia: a nationwide, population-based cohort study in south korea
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10651379/
https://www.ncbi.nlm.nih.gov/pubmed/36987382
http://dx.doi.org/10.5009/gnl220334
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