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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...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Editorial Office of Gut and Liver
2023
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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. |
format | Online Article Text |
id | pubmed-10651379 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Editorial Office of Gut and Liver |
record_format | MEDLINE/PubMed |
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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