Gastroesophageal Reflux Symptoms and Health-Related Quality of Life Among ICU Survivors

<h3>Background</h3> Gastroesophageal reflux disease (GERD) is a common clinical condition in the general population. However, no prospective study is available to estimate the burden of gastroesophageal reflux symptoms (GERSs) among survivors of the ICU. <h3>Research Question</h3> What are the incidence and severity of GERSs among survivors of the ICU? <h3>Study Design and Methods</h3> This prospective observational study was conducted in a 20-bed ICU at a university hospital in India. All adult survivors of the ICU were screened for the presence of GERSs, defined as presence of heartburn, regurgitation symptoms, or both ≥ 2 times/wk. Exclusions were: Glasgow Coma Scale score of < 15, presence of tracheostomy or feeding tube, open abdomen, and pregnancy. The severity of symptoms was assessed through the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score (range, 0-50, where 50 is worst) at 2 time points 6 weeks apart. <h3>Results</h3> During the study period, 116 patients were included, with a median age of 44 years (interquartile range [IQR], 26-59 years). Sixty-five patients (56%) were male, and the median admission Sequential Organ Failure Assessment score was 7 (IQR, 4-10). During the ICU stay, 59 patients (50.8%) required mechanical ventilation, 42 patients (36.2%) required vasopressors, and 11 patients (9.4%) received dialysis. Among them, 43 patients (37%) had history of GERSs before the illness. In the remaining 73 patients, 23 patients (31.5%) had new-onset GERSs. The use of medications known to increase the risk of GERD (eg, prednisolone, acetylsalicylic acid, and amlodipine) and the prolonged presence of a feeding tube were associated significantly with new-onset GERSs (OR, 4.49 [95% CI, 1.06-18.9; <i>P</i> = .04] and OR, 1.04 [95% CI, 1.00-1.09; <i>P</i> = .03]), respectively, even after adjusting for age and presence of preexisting known risk factors (diabetes, hypertension, and smoking and alcohol intake). The median GERD-HRQL score among patients with new-onset GERSs at follow-up decreased from 10 (IQR, 2-20) to 4 (IQR, 0-15; <i>P</i> = .01). <h3>Interpretation</h3> In this study, one-third of survivors of the ICU experienced new-onset GERSs. However, symptoms improved significantly at the 6-week follow-up. <h3>Clinical Trial Registration</h3> ClinicalTrials.gov; No.: NCT05193266; URL: www.clinicaltrials.gov