Development and validation of a new questionnaire for the evaluation of upper gastrointestinal symptoms in the elderly population: a multicenter study.

BACKGROUND: Several diagnostic questionnaires for evaluating upper gastrointestinal symptoms have been described; none of these, however, has been validated in older individuals. Objectives To develop and validate a diagnostic tool for evaluating upper gastrointestinal symptoms in older patients.

METHODS: A cohort of 206 older patients who underwent a upper gastrointestinal endoscopy (development cohort) was used for developing a 15-item upper gastrointestinal symptom questionnaire for the elderly population (UGISQUE), including five symptom clusters: (a) abdominal pain syndrome, (b) reflux syndrome, (c) indigestion syndrome, (d) bleeding, and (e) nonspecific symptoms. The questionnaire was then validated in a cohort of 326 older patients selected from those who underwent an upper gastrointestinal endoscopy in 15 gastroenterological centers in Italy (validation cohort).

RESULTS: The endoscopic diagnoses in the development and validation cohorts were esophagitis (E) 15.5% and 29.4%, erosive gastritis (EG) 24.8% and 24.8%, peptic ulcer (PU) 26.2% and 14.7%, and without organic lesions (WOL) 31.0% and 33.5%, respectively. In both the cohorts, patients with upper gastrointestinal disorders showed significantly more symptoms than WOL patients. The predictive value of UGISQUE for any pathological condition (E, EG, or PU) was good, with areas under the receiver-operating characteristic curve of .80, 95% confidence interval (CI) 0.743-0.864, and of .78, 95% CI 0.73-0.83, in the development and validation cohorts, respectively. The accuracy of UGISQUE was significantly higher than that for the individual clusters of symptoms in predicting the presence of E (p = .004), PU (p < .0001), or any pathological condition (p < .0001).

CONCLUSION: UGISQUE is an accurate diagnostic tool for evaluating symptoms in elderly patients with upper gastrointestinal disorders.