312 / 412
Statistical Analysis
For statistical analysis, SPSS, version 18.0 (SPSS), was used, and
all of the data are presented as mean (SD). A
t
test and analy-
sis of variance (ANOVA) were used to compare age differ-
ences in RSI, RFS, and LPR-HRQOL data. A repeated measure
of ANOVA was used to determine which age group showed a
greater response to PPI therapy. An ANOVA model in re-
peatedmeasures at 3 timepointswas usedwithBonferroni cor-
rection for multiple comparisons. Comparison of the propor-
tion of responders according to age was made using a χ
2
analysis. A difference was considered statistically significant
when the
P
value was less than .05.
Results
Study Populations
Of 264 consecutive patients considered for the study, 35 were
excluded because of loss of follow-up at 3 months. A total of
229 patients with LPRwere enrolled and completed the study
without loss to follow-up. Therewere 135men (59.0%) and 94
women (41.0%). Themean (SD; range) age of the patients was
55.7 (14.0; 18-79) years. Patientswere divided into 3 age groups
of 18 to 39, 40 to 59, and 60 to 79 years. The number of pa-
tients in each groupwas 35 (15.3%), 83 (36.2%), and 111 (48.5%),
respectively.
Difference of RSI, RFS, and LPR-HQOL
According to Age
The oldest patient group (60-79 years) with LPR had signifi-
cantly higher mean (SD) baseline RSI scores than the 18- to 39-
year-old and 40- to 59-year-old patient groups (18.45 [10.43]
vs 13.88 [7.68] and 12.20 [8.90], respectively;
P
< .001). How-
ever, the RFS score showed no significant difference among
age groups. The oldest patient group showed significantly
worse results on all domains of the LPR-HRQOL (all
P
< .001)
(
Table 1
).
Improvement of RSI, RFS, and LPR-HRQOL
After PPI Therapy
Within each age group, scores on all 3 tests improved signifi-
cantly during the period of PPI therapy; however, there was
no significant difference among groups in the amount of im-
provement (RSI,
P
= .59; RFS,
P
= .50; LPR-HRQOL,
P
= .09)
(
Table 2
).
Difference in Proportion of Responders on RSI
According to Age
Among the age groups, the proportion of responders, as evalu-
ated by RSI score, showed no significant difference at 1month;
however, responders were significantly more plentiful in the
2 younger groups than the oldest group at 3months (
P
= .002)
(
Table 3
).
Table 1. Initial Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and LPR–Health-Related Quality of Life (LPR-HRQOL) According to Age Group
Test
Score, Mean (SD)
P
Value
18-39 y
(n = 35)
40-59 y
(n = 83)
60-79 y
(n = 111)
RSI
13.88 (7.68)
12.20 (8.90)
18.45 (10.43)
<.001
RFS
6.78 (4.86)
7.18 (4.55)
7.75 (3.84)
.44
LPR-HRQOL
Voice
14.48 (18.65)
18.63 (21.36)
29.55 (21.17)
<.001
Cough
6.42 (7.36)
8.96 (7.36)
14.10 (12.40)
<.001
Throat clearing
6.97 (7.99)
6.15 (7.22)
12.78 (11.50)
<.001
Swallowing
6.05 (7.25)
6.40 (6.38)
11.31 (9.30)
<.001
Overall impact of acid reflux
21.28 (18.46)
21.45 (14.72)
34.81 (23.26)
<.001
Table 2. Improvement in Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and LPR–Health-Related Quality of Life (LPR-HRQOL) After Proton
Pump Inhibitor Therapy According to Age
Test
Score, Mean (SD)
P
Value
Baseline
1 Month
3 Months
Within Group Among Groups
RSI
18-39 y
13.88 (7.68)
8.77 (6.80)
4.62 (5.35)
<.001
.59
40-59 y
12.20 (8.90)
7.57 (7.31)
5.32 (6.28)
<.001
60-79 y
18.45 (10.43)
12.89 (9.15)
10.81 (9.86)
<.001
RFS
18-39 y
6.21 (4.87)
3.89 (3.10)
2.92 (2.59)
<.001
.50
40-59 y
6.46 (4.70)
4.34 (3.36)
2.98 (2.66)
<.001
60-79 y
7.74 (3.92)
5.76 (3.39)
4.40 (2.67)
<.001
LPR-HRQOL
18-39 y
21.50 (19.29)
14.28 (8.38)
11.93 (4.13)
<.001
.09
40-59 y
20.81 (14.50)
17.41 (12.40)
14.02 (8.03)
<.001
60-79 y
35.20 (23.29)
24.27 (17.57)
23.08 (19.15)
<.001
Age and Proton Pump Inhibitor Treatment
Original Investigation
Research
jamaotolaryngology.comJAMAOtolaryngology–Head &Neck Surgery
December 2013
Volume
139, Number
12
Copyright 2013 American Medical Association. All rights reserved.
87