Imperfect high‐resolution manometry studies: Prevalence and predictive factors

Background Imperfect high‐resolution manometry (HRM) studies can impact clinical management of patients with esophageal symptoms. Methods Esophageal high‐resolution manometry (HRM) studies attempted and/or performed by trained motility operators at a tertiary care center over a 2‐year period were identified. When studies were attempted but not completed, reasons for an imperfect study (critically imperfect = LES not adequately traversed; non‐critically imperfect = diaphragm not traversed), and point of identification (identified by motility nurse vs. identified on physician review) were recorded. Prevalence and clinical predictors of critically and non‐critically imperfect studies were determined. Key Results Of 962 HRM studies attempted in 951 patients, 33 (3.4%) were critically imperfect (17 curled catheters), and 125 (13.0%) were non‐critically imperfect. A third of critically imperfect studies, and 64.7% of curled catheters had achalasia, while 99.2% of non‐critically imperfect studies had large hiatus hernias. Motility nurses detected 90.9% of critically imperfect and 55.8% of non‐critically imperfect studies in real‐time (p