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Life expectancy, complications, and causes of death in patients with achalasia: results of a 33-year follow-up investigation.

Abstract：

BACKGROUND:Patients with achalasia require repeated invasive therapies and may experience multiple complications. The objectives of this study were to determine the incidence of such complications, causes of death, and life expectancy in 253 patients. METHODS:Patients consisted of two groups: group A comprised 177 patients with newly diagnosed achalasia; group B consisted of 76 patients in whom the diagnosis had been established in external institutions. All patients regularly underwent structured interviews and were reinvestigated if changes in health status occurred. Survival rates were determined by Kaplan-Meier estimates and were compared with those of an average German population. Causes of death were determined from hospital records, information supplied by private physicians, and from death certificates. RESULTS:Complete follow-up was obtained in 98.9% (group A) and in 100% (group B) of all patients. The observation period for group A ranged from 2 to 33 years and for group B from 2 to 26 years (disease duration: 4-68 years). The most frequent complications were reflux esophagitis (group A: 6.2%, group B: 19.7%) and megaesophagus (group A: 6.2%, group B: 21.0%). Thirty-six patients had died during follow-up. Five of these deaths were related to achalasia. In group A, the estimated 20-year survival rates in patients with achalasia [76% (95% confidence interval (CI): 66-85%)] did not significantly differ from those in controls 80% (95% CI: 71-89%). In group B, 25-year survival rates were also similar in patients [87% (95% CI: 78-97%)] and controls [86% (95% CI: 76-97%)]. CONCLUSION:Patients with achalasia experience a significant number of complications. Causes of death and life expectancy, however, do not differ from those of the average population.

journal_name

Eur J Gastroenterol Hepatol

journal_title

European journal of gastroenterology & hepatology

authors

Eckardt VF,Hoischen T,Bernhard G

doi

10.1097/MEG.0b013e3282fbf5e5

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

956-60

issue

eissn

0954-691X

issn

1473-5687

pii

00042737-200810000-00002

journal_volume

pub_type

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Life expectancy, complications, and causes of death in patients with achalasia: results of a 33-year follow-up investigation.