Impact of risk factors on the severity of esophageal mucosal injury in patients with gastroesophageal reflux disease

Objective To assess the risk factors that could influence the severity of esophageal inju- ry in patients with gastroesophageal reflux disease(GERD).Methods GERD patients diagnosed on the ba- sis of endoscopic reflux esophagitis or pathological results of 24 hour esophageal pH monitoring were divided into three groups as non-erosive reflux disease group(NERD)(n=83),mild esophagitis group(n=51) and severe esophagitis group(n=22).The clinic data and esophageal pH parameters were recorded in the three groups.A logistic regression was used to assess the joint influences of clinic characteristics,hiatus her- nia,and esophageal pH parameters on the severity of esophageal injury.Results Patients in severe esoph- agitis group were more likely to have advanced age and hiatus hernia.The number of supine long reflux epi- sodes measured by esophageal pH monitoring significantly increased with increasing grades of mueosal dam- age(P0.05).No significant association between other individual parameters of esophageal pH monitoring and the severity of mucosal damage could be established.In the logistic regression,the presence of hiatus hernia was the only independent factor associated with the severity of esophageal injury(OR=15.032,95% CI:3.767-22.723,P0.01).Conclusion In Chinese GERD patients,the proportion of patients with advanced age,male gender,number of supine long reflux episodes and hiatus hernia increase in patients with severe esophageal mucosal damage.The presence of hiatus hernia is a very important risk factor in the severi- ty of esophageal injury.