Faculty Collaboration Database

Gastroesophageal Reflux Burden, Even in Children That Aspirate, Does Not Increase Pediatric Hospitalization. J Pediatr Gastroenterol Nutr 2016 Aug;63(2):210-7

Date

01/23/2016

Pubmed ID

26794490

Pubmed Central ID

PMC4917472

DOI

10.1097/MPG.0000000000001092

Scopus ID

2-s2.0-84979732334 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

OBJECTIVES: Gastroesophageal reflux is common but remains a controversial disease to diagnose and treat and little is known about the role of reflux testing in predicting clinical outcomes, particularly in children at risk for extraesophageal reflux complications. The aim of this study was to determine if rates of hospitalization were affected by reflux burden even after adjusting for aspiration risk.

METHODS: We prospectively recruited, between 2009 and 2014, a cohort of pediatric patients with suspected extraesophageal reflux disease who were referred for reflux testing and underwent both multichannel intraluminal impedance with pH (pH-MII) and modified barium swallow studies. A subset of patients also underwent bronchoalveolar lavage with pepsin analysis. We determined their rates of hospitalization for a minimum of 1 year following pH-MII testing.

RESULTS: We prospectively enrolled 116 pediatric patients who presented for care at Boston Children's Hospital and underwent both pH-MII and modified barium swallow studies. There was no statistically significant relationship between reflux burden measured by pH-MII or bronchoalveolar pepsin and total number of admissions or number of admission nights even after adjusting for aspiration status (P > 0.2). There were no statistically significant relationships between reflux burden by any method and the number or nights of urgent pulmonary admissions before or after adjusting for aspiration risk (P > 0.08).

CONCLUSIONS: Even in aspirating children, reflux burden did not increase the risk of hospitalization. Based on these results, routine reflux testing cannot be recommended even in aspirating children, because the results do not impact clinically significant outcomes.

Author List

Duncan DR, Amirault J, Johnston N, Mitchell P, Larson K, Rosen RL

Author

Nikki Johnston PhD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Boston
Child
Child, Preschool
Cost of Illness
Female
Follow-Up Studies
Gastroesophageal Reflux
Hospitalization
Hospitals, Pediatric
Humans
Infant
Male
Prognosis
Prospective Studies
Respiratory Aspiration
Risk Assessment