An epidemiological survey of laryngopharyngeal reflux disease at the otorhinolaryngology-head and neck surgery clinics in China

Shuifang Xiao; Jinrang Li; Hongliang Zheng; Yan Yan; Xiangping Li; Lihong Zhang; Quiping Lv; Junbo Zhang; Lin Zeng; Xia Gao; Xiong Chen; Hui Yang; Chen Zhao; Jian Zhang; Honghua Lu; Xianyang Luo; Guangke Wang; Hongliang Yi; Jin Ye; Zhenqun Lin; Linli Tian; Jingjing Zhang; Ting Chen; Aimin Yu; Zhaohui Liu; Xiaoyong Ren; Xinming Yang; Siyi Zhang; Xiaobo Cui; Gelin Li; Guanglun Wan; Chang Lin; Hui Chen; Anchun Deng; Xiabing Tang; Qingfeng Zhang; Zhenfeng Tao; Li Shi; Jianyong Zhou; Gang Qin; Peiyun Zhuang; Hui Huangfu; Jianming Yang; Guojin Zhou; Huijun Li; Wei Wu; Julan Li; Shuhua Li; Guangming Lou; Hongyan Fang; Jiangang Ma; Chunguang Shan; Xuejun Zhou; Liang Tang; Fang Zhou; Yunping Fan; Yanping Zhang; Yujie Li; Meisheng Li; Chunqiang Dou; Zhiling Chen; Gang Lei; Jingbo Li; Zhiguang Gao; Yongwang Huang; Xinchun Ma; Zhijun Liu; Gengtian Liang; Jian He; Hua Zhao; Bailong Song; Meijun Chen; Xiangli Yang; Zuopeng Ma; Jinlong Ren

doi:10.1007/s00405-020-06045-0

An epidemiological survey of laryngopharyngeal reflux disease at the otorhinolaryngology-head and neck surgery clinics in China

Eur Arch Otorhinolaryngol. 2020 Oct;277(10):2829-2838. doi: 10.1007/s00405-020-06045-0. Epub 2020 May 25.

Authors

Shuifang Xiao¹, Jinrang Li², Hongliang Zheng³, Yan Yan⁴, Xiangping Li⁵, Lihong Zhang⁶, Quiping Lv⁷, Junbo Zhang⁸, Lin Zeng⁹, Xia Gao¹⁰, Xiong Chen^{11

12}, Hui Yang¹³, Chen Zhao¹⁴, Jian Zhang¹⁵, Honghua Lu¹⁶, Xianyang Luo¹⁷, Guangke Wang¹⁸, Hongliang Yi¹⁹, Jin Ye²⁰, Zhenqun Lin²¹, Linli Tian²², Jingjing Zhang²³, Ting Chen²⁴, Aimin Yu²⁵, Zhaohui Liu²⁶, Xiaoyong Ren²⁷, Xinming Yang²⁸, Siyi Zhang²⁹, Xiaobo Cui³⁰, Gelin Li³¹, Guanglun Wan³², Chang Lin³³, Hui Chen³⁴, Anchun Deng³⁵, Xiabing Tang³⁶, Qingfeng Zhang^{37

38}, Zhenfeng Tao³⁹, Li Shi⁴⁰, Jianyong Zhou⁴¹, Gang Qin⁴², Peiyun Zhuang⁴³, Hui Huangfu⁴⁴, Jianming Yang⁴⁵, Guojin Zhou⁴⁶, Huijun Li⁴⁷, Wei Wu⁴⁸, Julan Li⁴⁹, Shuhua Li⁵⁰, Guangming Lou⁵¹, Hongyan Fang⁵², Jiangang Ma⁵³, Chunguang Shan⁵³, Xuejun Zhou⁵⁴, Liang Tang⁵⁵, Fang Zhou⁵⁶, Yunping Fan⁵⁷, Yanping Zhang⁵⁸, Yujie Li⁵⁹, Meisheng Li⁶⁰, Chunqiang Dou⁶¹, Zhiling Chen⁶², Gang Lei⁶³, Jingbo Li⁶⁴, Zhiguang Gao⁶⁵, Yongwang Huang⁶⁶, Xinchun Ma⁶⁷, Zhijun Liu⁶⁸, Gengtian Liang⁶⁹, Jian He⁷⁰, Hua Zhao⁷¹, Bailong Song⁷², Meijun Chen⁷³, Xiangli Yang⁷⁴, Zuopeng Ma⁷⁵, Jinlong Ren⁷⁶

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Peking University First Hospital, 8# Xishiku Street, Western District, Beijing, 100034, China. [email protected].
² Department of Otorhinolaryngology, Head and Neck Surgery, The Sixth Medical Center of Chinese PLA General Hospital, 6# Fucheng Road, Haidian District, Beijing, 100048, China. [email protected].
³ Department of Otorhinolaryngology, Head and Neck Surgery, Changhai Hospital, Second Military Medical University, 168# Changhai Street, Yangpu District, Shanghai, 200433, China. [email protected].
⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Peking University Third Hospital, Beijing, China.
⁵ Department of Otorhinolaryngology, Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China.
⁷ Department of Otorhinolaryngology, Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, China.
⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Peking University First Hospital, 8# Xishiku Street, Western District, Beijing, 100034, China.
⁹ Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
¹⁰ Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China.
¹¹ Department of Otorhinolaryngology, Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
¹² Department of Otorhinolaryngology, Head and Neck Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
¹³ Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
¹⁴ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China.
¹⁵ Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
¹⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China.
¹⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
¹⁸ Department of Otorhinolaryngology Head and Neck Surgery, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
¹⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Sixth People's Hospital of Shanghai Jiaotong University, Shanghai, China.
²⁰ Department of Otorhinolaryngology, Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
²¹ Department of Otorhinolaryngology, Head and Neck Surgery, Hainan Provincial People's Hospital, Hiakou, Hainan, China.
²² Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
²³ Department of Otorhinolaryngology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
²⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Fujian Provincial Hospital, Fuzhou, Fujian, China.
²⁵ Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Medical School, Yangzhou University, Yangzhou, Jiangsu, China.
²⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China.
²⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
²⁸ Department of Otorhinolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
²⁹ Department of Otorhinolaryngology Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.
³⁰ Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China.
³¹ Department of Otorhinolaryngology, Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
³² Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Hospital, Hefei, Anhui, China.
³³ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
³⁴ Department of Otorhinolaryngology, Head and Neck Surgery, Chengdu First People's Hospital, Chengdu, Sichuan, China.
³⁵ Department of Otorhinolaryngology, Head and Neck Surgery, Xinqiao Hospital, Army Military Medical University, Chongqing, China.
³⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Wuxi People's Hospital, Wuxi, Jiangsu, China.
³⁷ Department of Otorhinolaryngology, Head and Neck Surgery, Dalian Central Hospital, Dalian, Liaoning, China.
³⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Shenzhen University General Hospital, Shenzhen, Guangdong, China.
³⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.
⁴⁰ Department of Otorhinolaryngology, Head and Neck Surgery, Xijing Hospital, Air Force Military Medical University, Xi'an, Shaanxi, China.
⁴¹ Department of Otorhinolaryngology Head and Neck Surgery, Jiangmen Central Hospital, Jiangmen, Guangdong, China.
⁴² Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
⁴³ Department of Voice, Zhongshan Hospital, Xiamen University, Xiamen, Fujian, China.
⁴⁴ Department of Otorhinolaryngology, Head and Neck Surgery, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
⁴⁵ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
⁴⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, Zhejiang, China.
⁴⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
⁴⁸ Department of Otorhinolaryngology, Head and Neck Surgery, PLA Strategic Support Force Characteristic Medical Center, Beijing, China.
⁴⁹ Department of Otorhinolaryngology Head and Neck Surgery, Sichuan Provincial Corps Hospital, Chinese People's Armed Police Force, Leshan, Sichuan, China.
⁵⁰ Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning, China.
⁵¹ Department of Otorhinolaryngology Head and Neck Surgery, The First Hospital of Longyan City, Longyan, Fujian, China.
⁵² Department of Otorhinolaryngology Head and Neck Surgery, Chongqing General Hospital, Chongqing, China.
⁵³ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
⁵⁴ Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Hainan Medical College, Haikou, Hainan, China.
⁵⁵ Department of Otorhinolaryngology, Head and Neck Surgery, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China.
⁵⁶ Department of Otorhinolaryngology Head and Neck Surgery, Changsha Central Hospital, Changsha, Hunan, China.
⁵⁷ Department of Otorhinolaryngology Head and Neck Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
⁵⁸ Department of Otorhinolaryngology Head and Neck Surgery, The 8th Medical Center of Chinese PLA General Hospital, Beijing, China.
⁵⁹ Department of Otorhinolaryngology Head and Neck Surgery, Zhengzhou Central Hospital, Zhengzhou, Henan, China.
⁶⁰ Department of Otorhinolaryngology Head and Neck Surgery, The First People's Hospital of Shangqiu City, Shangqiu, Henan, China.
⁶¹ Department of Otorhinolaryngology, Head and Neck Surgery, Linfen People's Hospital, Linfen, Shanxi, China.
⁶² Department of Otorhinolaryngology, Head and Neck Surgery, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
⁶³ Department of Otorhinolaryngology Head and Neck Surgery, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
⁶⁴ Department of Otorhinolaryngology Head and Neck Surgery, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, Henan, China.
⁶⁵ Department of Otorhinolaryngology Head and Neck Surgery, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, China.
⁶⁶ Department of Otorhinolaryngology, Head and Neck Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China.
⁶⁷ Department of Otorhinolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
⁶⁸ Department of Otorhinolaryngology, Head and Neck Surgery, Chizhou People's Hospital, Chizhou, Anhui, China.
⁶⁹ Department of Otorhinolaryngology, Head and Neck Surgery, Wuhan Third Hospital, Wuhan, Hubei, China.
⁷⁰ Department of Otorhinolaryngology, Head and Neck Surgery, Gansu Provincial Hospital, Lanzhou, Gansu, China.
⁷¹ Department of Otorhinolaryngology Head and Neck Surgery, Xinjiang Military Command General Hospital, Urumqi, Xinjiang, China.
⁷² Department of Otorhinolaryngology, Head and Neck Surgery, Affiliated Hospital of Chifeng College, Chifeng, Inner Mongolia, China.
⁷³ Department of Otorhinolaryngology Head and Neck Surgery, The People's Hospital of Dazu District, Chongqing, China.
⁷⁴ Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Union Medical Center, Tianjin, China.
⁷⁵ Department of Otorhinolaryngology Head and Neck Surgery, Qinghai Red Cross Hospital, Xining, Qinghai, China.
⁷⁶ Department of Otorhinolaryngology, Head and Neck Surgery, Fenyang Hospital, Shanxi Province, Fenyang, Shanxi, China.

PMID: 32449029
DOI: 10.1007/s00405-020-06045-0

Abstract

Purpose: Using the Reflux Symptom Index (RSI), this nationwide study aimed to investigate the incidence, diagnostic status, risk factors, and common symptoms of adult laryngopharyngeal reflux disease (LPRD) at otorhinolaryngology-head and neck surgery (OHNS) clinics in China.

Methods: This multicenter cross-sectional survey began at the different institutions ranged from July to October 2017, and the duration was 12 months. A total of 90,440 eligible patients were finally enrolled from 72 medical institutions in China. All these patients completed the questionnaire based on RSI. In this study, LPRD was defined as RSI > 13.

Results: There were 9182 with LPRD among the 90,440 eligible participants (10.15%). However, only 1294 had a history of LPRD diagnosis among those with LPRD (14.09%). There were regional differences in the frequency of LPRD (P < 0.001). The proportions of patients with LPRD in males (vs. females), middle- and old-aged patients (vs. young), with current smoking history (vs. no smoking), and current drinking history (vs. no drinking) were significantly higher (all P < 0.001). Middle and old age, current smoking, and drinking history were independent predictors of LPRD (all P < 0.001, OR 1.240, 1.261, and 1.481, respectively). "Sensations of something stuck in throat or a lump in throat", "clearing throat", and "excess throat mucus or postnasal drip" were the most frequent clinical symptoms in patients with LPRD.

Conclusions: LPRD has a high incidence at the OHNS clinics in China. However, the diagnostic status of this disease is not optimistic. Older age, smoking, and drinking history were risk factors for LPRD.

Keywords: Cross-sectional survey; Laryngopharyngeal reflux; Multi-center; Otorhinolaryngology.

Publication types

Multicenter Study

MeSH terms

Adult
Aged
China / epidemiology
Cross-Sectional Studies
Female
Humans
Laryngopharyngeal Reflux* / diagnosis
Laryngopharyngeal Reflux* / epidemiology
Male
Middle Aged
Otolaryngology*
Surveys and Questionnaires