Esophageal motor dysfunction in systemic sclerosis: clinical predictors and a risk stratification model

Area of Science:

• Gastroenterology
• Rheumatology
• Medical Diagnostics

Background:

• High-resolution esophageal manometry (HRM) is crucial for evaluating esophageal motor abnormalities in systemic sclerosis (SSc).
• Limited data exists on esophageal dysfunction in SSc patients from Latin America.
• The Chicago Classification (2010-2022) provides a framework for classifying esophageal motility disorders.

Purpose of the Study:

• To determine the prevalence of esophageal motor dysfunction in SSc patients.
• To identify clinical predictors of esophageal motor dysfunction in SSc.
• To develop a clinical prediction score for esophageal involvement in SSc.

Main Methods:

• Retrospective cross-sectional study of adult SSc patients undergoing HRM (2010-2022).
• Esophageal motor function classified using Chicago Classification criteria.
• Logistic regression analysis identified predictors; a clinical prediction score was developed.

Main Results:

• 73% of 127 SSc patients exhibited esophageal motor dysfunction.
• Regurgitation, digital pitting scars, and reduced diffusion capacity (≤80%) were independent predictors.
• A clinical prediction score effectively stratified the probability of esophageal involvement.

Conclusions:

• Esophageal motor dysfunction is highly prevalent in SSc patients.
• A simple clinical prediction tool can identify patients with esophageal involvement.
• This tool can guide diagnostic evaluation, especially in resource-limited settings.