Tu1301 – Increased Frequency of Giant Paraesophageal Hernia Repair At a Safety Net Hospital

Introductions: Dysphagia is considered an alarm symptom and usually requires Endoscopy.However not all patients with dysphagia harbor malignancy.This study evaluates the other co-founding factors that may predict malignancy in Sri Lankan patients presenting with dysphagia.Methods: This is a retrospective descriptive study.Data from adult patients who underwent upper gastrointestinal endoscopy for dysphagia from January 2017 to July 2018 in two tertiary referral centers (Kandy and Kalubowila) were analyzed.Results: Out of 306 patients with dysphagia 61(19.9%)had malignancy.Patient with malignancy had a higher mean age (65 ± 12.6 vs. 60 ± 14.1 years) and a shorter duration of dysphagia (12 ± 7 vs. 28 ± 25 weeks).Pearson's Chi-Squared test revealed that presence of malignancy associated with gender (8.94, p = 0.003) and location (17.02, p < 0.05).According to logistic regression patients age (p=0.018),gender (p=0.022) and location (p<0.05) were statistically significant in predicting the presence of a tumor.Odds of having malignancy increased by 2.8% for each year of increase in age.Male have 2 times (95% CI; 1.105 to 3.672) higher odds of having a tumor compared to females (p=0.034)controlling for age and location.Kandy location have a 3 times (95% CI; 0.175 to 0.575) higher odds of having a tumor compared to Kalubowila (p=0.000)controlling for age and gender.Conclusion: Male gender, advance age and Kandy location are high risk factors.Other significant predictors of malignancy in patients with dysphagia need to be assessed with a larger sample size.