Epidemiology and Healthcare Utilization in Patients With Gastroparesis: A Systematic Review

Background & Aims: The authors performed a systematic review of epidemiologic data to understand the prevalence, incidence, etiologies, and hospitalizations related to gastroparesis (GP). Methods: Studies of the epidemiology of GP published in all languages, years, and countries from 5 databases in January 2022 were studied using prespecified search strategies. Results: Thirteen studies (data from 1994 to 2019) were included. All but one study (from the United Kingdom) were based in the United States. Prevalence of definite GP (symptoms plus delayed gastric emptying) ranged from 13.8 to 267.7 per 100,000 adults, and incidence was 1.9–6.3 per 100,000 person-years. The estimated 10-year cumulative incidence of GP in type 1 diabetes (DM) and type 2 DM was 5.2% and 1.0%, respectively. Across studies, GP was more common among female patients and those with DM. Rates of hospitalizations and emergency department visits for GP are increasing, ranging from 2- to 18-fold over approximately 2 decades. Mortality rates for patients with possible or definite GP were higher compared with the general population, with primary causes of death in GP being cardiovascular, respiratory failure, and malignancy. Multiple studies observed improved inpatient mortality over the mid-1990s to late 2000s. Limitations include the case identification in most studies (76.9%) used solely International Classification of Diseases codes or clinical record diagnoses; 2 studies (15.4%) used objective evaluation to diagnose GP. Only 4 studies (30.8%) used non-specialized community databases; the remaining 9 studies used inpatient, emergency department, or disease-specific databases. Conclusions: There is a paucity of high-quality, demographically diverse, and population-based studies to accurately describe the epidemiology of GP. Future studies with valid gastric emptying measurement are needed to better characterize the epidemiology and natural history of GP.