Predictive value of alarm symptoms in patients with Rome IV dyspepsia: A cross-sectional study

Table 1 Baseline characteristics of all participants and univariate analyses of various predictive variables for organic dyspepsia

Characteristics	Full participants, n = 381	FD, n = 266	Organic dyspepsia, n = 115	P value
Age in yr	49.9 ± 13.0	49.6 ± 12.9	50.5 ± 13.4	0.706
BMI in kg/m2	21.9 ± 3.3	21.9 ± 3.5	21.7 ± 2.9	0.682
Gender, M/F	150/231	107/159	43/72	0.603
Race, Han/minority	377/4	262/4	115/0	0.320
Location, Shaanxi/other	324/57	226/40	98/17	0.949
Job category				0.980
Physical	130 (34.1)	90 (33.8)	40 (34.8)
Mental	96 (25.2)	67 (25.2)	29 (25.2)
Middle	101 (26.5)	70 (26.3)	31 (27.0)
Retire	54 (14.2)	39 (14.7)	15 (13.0)
Marriage				1.000
Never married	19 (5.0)	13 (4.9)	6 (5.2)
Married	362 (95.0)	253 (95.1)	109 (94.8)
Daily exercise				0.048
< 1/2 h	27 (7.1)	18 (6.8)	9 (7.8)
1/2-1 h	96 (25.2)	69 (25.9)	27 (23.5)
1-2 h	63 (16.5)	35 (13.2)	28 (24.3)
> 2 h	195 (51.2)	144 (54.1)	51 (44.3)
Spicy food	206 (54.1)	145 (54.5)	61 (53.0)	0.792
Smoking				0.720
< half pack a day	335 (87.9)	235 (88.3)	100 (87.0)
> half pack a day	46 (12.1)	31 (11.7)	15 (13.0)
Alcohol	72 (18.9)	50 (18.8)	22 (19.1)	0.939
Sleep, good/bad	238/143	168/98	70/45	0.672
Outpatient cost				0.060
< 500	2 (0.5)	1 (0.4)	1 (0.9)
500-1000	46 (12.1)	40 (15.0)	6 (5.2)
1000-3000	107 (28.1)	76 (28.6)	31 (27.0)
3000-5000	41 (10.8)	29 (10.9)	12 (10.4)
> 5000	185 (48.5)	120 (45.1)	65 (56.5)
Educational level				0.791
Elementary and below	175 (45.9)	122 (45.9)	53 (46.1)
High school	84 (22.1)	61 (22.9)	23 (20.0)
College	109 (28.6)	73 (27.4)	36 (31.3)
Postgraduate and above	13 (3.4)	10 (3.8)	3 (2.6)
Previous visits				0.443
0	106 (27.8)	80 (30.1)	26 (22.6)
1	72 (18.9)	49 (18.4)	23 (20.0)
2	32 (8.4)	20 (7.5)	12 (10.4)
≥ 3	171 (44.9)	117 (44.0)	54 (47.0)
Weight loss				0.238
No	277 (72.7)	199 (74.8)	78 (67.8)
< 7 lb	50 (13.1)	30 (11.3)	20 (17.4)
≥ 7 lb	54 (14.2)	37 (13.9)	17 (14.8)
Anemia, yes/no	31/350	0/266	31/84	< 0.001
Anorexia, yes/no	94/287	66/200	28/87	0.923
Vomiting, yes/no	22/359	14/252	8/107	0.485
Melena, yes/no	23/358	16/250	7/108	1.000
Dysphagia, yes/no	3/378	1/265	2/113	0.218
Family history				0.204
None	331 (86.9)	235 (88.3)	96 (83.5)
Esophagus cancer	13 (3.4)	10 (3.8)	3 (2.6)
Gastric cancer	24 (6.3)	15 (5.6)	9 (7.8)
Other	13 (3.4)	6 (2.3)	7 (6.1)
Alarm symptoms				0.004
No	161 (42.3)	125 (47.0)	36 (31.3)
Yes	220 (57.7)	141 (53.0)	79 (68.7)
Number of alarm symptoms				0.001
0	161 (42.3)	125 (47.0)	36 (31.3)
1	139 (36.5)	96 (36.1)	43 (37.4)
2	59 (15.5)	37 (13.9)	22 (19.1)
3	18 (4.7)	7 (2.6)	11 (9.6)
4	4 (1.0)	1 (0.4)	3 (2.6)

Values are expressed as the mean ± standard deviation or n (%). BMI: Body mass index; M: Male; F: Female; FD: Functional dyspepsia.

Table 2 Univariate and multivariate analysis of various predictive variables for organic upper gastrointestinal diseases

Characteristics	FD, n = 266	Organic upper GI disease, n = 24	Univariate analysis	Multivariate analysis
			P value	OR	95%CI	P value
Age in yr	49.6 ± 12.9	54.8 ± 14.8	0.071	1.056	1.012-1.101	0.012
BMI in kg/m2	21.9 ± 3.5	21.5 ± 2.1	0.635
Gender, M/F	107/159	10/14	1.000
Race, Han/minority	262/4	24/0	1.000
Location, Shaanxi/other	226/40	19/5	0.553
Job category			0.629
Physical	90 (33.8)	8 (33.3)
Mental	67 (25.2)	4 (16.7)
Middle	70 (26.3)	9 (37.5)
Retire	39 (14.7)	3 (12.5)
Marriage			0.136
Never married	13 (4.9)	3 (12.5)
Married	253 (95.1)	21 (87.5)
Daily exercise			0.128
< 1/2 h	18 (6.8)	0 (0)
1/2-1 h	69 (25.9)	3 (12.5)
1-2 h	35 (13.2)	6 (25.0)
> 2 h	144 (54.1)	15 (62.5)
Spicy food	145 (54.5)	14 (58.3)	0.719
Smoking			0.024
< half pack a day	235 (88.3)	17 (70.8)
> half pack a day	31 (11.7)	7 (29.2)		4.714	1.569-14.16	0.006
Alcohol	50 (18.8)	5 (20.8)	0.788
Sleep, good/bad	168/98	16/8	0.827
Outpatient cost			0.363
< 500	1 (0.4)	0
500-1000	40 (15.0)	1 (4.2)
1000-3000	76 (28.6)	7 (29.2)
3000-5000	29 (10.9)	1 (4.2)
> 5000	120 (45.1)	15 (62.5)
Educational level			0.789
Elementary and below	122 (45.9)	12 (50.0)
High school	61 (22.9)	5 (20.8)
College	73 (27.4)	7 (29.2)
Postgraduate and above	10 (3.8)	0
Previous visits			0.637
0	80 (30.1)	9 (37.5)
1	49 (18.4)	4 (16.7)
2	20 (7.5)	3 (12.5)
≥ 3	117 (44.0)	8 (33.3)
Weight loss			0.380
No	199 (74.8)	16 (66.7)
< 7 lb	30 (11.3)	5 (20.8)
≥ 7 lb	37 (13.9)	3 (12.5)
Anemia, yes/no	0/266	5/19	< 0.001	88.27	15.486-∞	< 0.001
Anorexia, yes/no	66/200	9/15	0.222
Vomiting, yes/no	14/252	3/21	0.156
Melena, yes/no	16/250	3/21	0.200
Dysphagia, yes/no	1/265	1/23	0.159
Family history			0.627
None	235 (88.3)	22 (91.7)
Esophagus cancer	10 (3.8)	0
Gastric cancer	15 (5.6)	2 (8.3)
Other	6 (2.3)	0
Alarm symptoms			0.038
No	125 (47.0)	6 (25.0)
Yes	141 (53.0)	18 (75.0)
Number of alarm symptoms			0.009
0	125 (47.0)	6 (25.0)
1	96 (36.1)	10 (41.7)
2	37 (13.9)	4 (16.7)
3	7 (2.6)	3 (12.5)
4	1 (0.4)	1 (4.2)

Values are expressed as the mean ± standard deviation or n (%). BMI: Body mass index; M: Male; F: Female; FD: Functional dyspepsia; OR: Odds ratio; CI: Confidence interval.

Table 3 Characteristics of patients with epigastric pain syndrome and postprandial distress syndrome

Characteristics	EPS, n = 174	PDS, n = 31	EPS and PDS, n = 61	P value
Age in yr	49.2 ± 12.7	49.1 ± 12.7	50.8 ± 13.5	0.638
BMI in kg/m2	22.3 ± 3.5	21.2 ± 2.7	21.3 ± 3.8	0.062
Gender, M/F	70/104	14/17	23/38	0.788
Race, Han/minority	170/4	31/0	61/0	0.742
Location, Shaanxi/other	147/27	28/3	51/10	0.733
Job category				0.172
Physical	59 (33.9)	11 (35.5)	20 (32.8)
Mental	49 (28.2)	8 (25.8)	10 (16.4)
Middle	44 (25.3)	10 (32.3)	16 (26.2)
Retire	22 (12.6)	2 (6.5)	15 (24.6)
Marriage				0.615
Never married	7 (4.0)	2 (6.5)	4 (6.6)
Married	167 (96.0)	29 (93.5)	57 (93.4)
Daily exercise				0.993
< 1/2 h	12 (6.9)	2 (6.5)	4 (6.6)
1/2-1 h	47 (27.0)	7 (22.6)	15 (24.6)
1-2 h	24 (13.8)	4 (12.9)	7 (11.5)
> 2 h	91 (52.3)	18 (58.1)	35 (57.4)
Spicy food	94 (54.0)	22 (71.0)	29 (47.5)	0.100
Smoking				0.225
No	149 (85.6)	24 (77.4)	46 (75.4)
< half pack a day	11 (6.3)	2 (6.5)	3 (4.9)
half pack-one pack a day	5 (2.9)	1 (3.2)	2 (3.3)
> one pack a day	9 (5.2)	4 (12.9)	10 (16.4)
Alcohol	29 (16.7)	9 (29.9)	12 (19.7)	0.265
Sleep, good/bad	115/59	18/13	35/26	0.393
Outpatient cost				0.672
< 500	1 (0.6)	0	0
500-1000	30 (17.2)	5 (16.1)	5 (8.2)
1000-3000	51 (29.3)	10 (32.3)	15 (24.6)
3000-5000	18 (10.3)	4 (12.9)	7 (11.5)
> 5000	74 (42.5)	12 (38.7)	34 (55.7)
Educational level				0.166
Elementary and below	76 (43.7)	11 (35.5)	35 (57.4)
High school	37 (21.3)	10 (32.3)	14 (23.0)
College	53 (30.5)	10 (32.3)	10 (16.4)
Postgraduate and above	8 (4.6)	0	2 (3.3)
Previous visits				0.012
0	59 (33.9)	13 (41.9)	8 (13.1)
1	36 (20.7)	3 (9.7)	10 (16.4)
2	12 (6.9)	3 (9.7)	5 (8.2)
≥ 3	67 (38.5)	12 (38.7)	38 (62.3)
Weight loss				0.637
No	133 (76.4)	24 (77.4)	42 (68.9)
< 7 lb	20 (11.5)	2 (6.5)	8 (13.1)
≥ 7 lb	21 (12.1)	5 (16.1)	11 (18.0)
Anorexia, yes/no	34/140	10/21	22/39	0.021
Vomiting, yes/no	11/163	0/31	3/58	0.535
Melena, yes/no	9/165	4/27	3/58	0.236
Dysphagia, yes/no	0/174	1/30	0/61	0.117
Family history				0.743
None	151 (86.8)	28 (90.3)	56 (91.8)
Esophagus cancer	7 (4.0)	1 (3.2)	2 (3.3)
Gastric cancer	10 (5.7)	2 (6.5)	3 (4.9)
Other	6 (3.4)	0	0

Values are expressed as the mean ± standard deviation or n (%). BMI: Body mass index; M: Male; F: Female; EPS: Epigastric pain syndrome; PDS: Postprandial distress syndrome.