In various studies of patients with ZES a number of specific disease-related features have been reported to have prognostic significance, including disease duration,476 extent of hypergastrinemia,191,292,397,405,459,476,484 BAO,191,476 presence of peptic ulcer disease or its complications,108,117,191,199,200,483 previous gastric acid reducing surgery,476 and antisecretory drug used.476 We compared each of these features in NIH patients by survival status (Table 4). There was no significant difference between the alive and deceased NIH patients in the duration of ZES to last follow-up, the increment in gastrin during the secretin test (delta secretin), the duration or type of antisecretory treatment, peptic ulcer disease history, or occurrence of bleeding or other peptic ulcer disease complications. In contrast, deceased patients were more likely than alive patients to have had a very high fasting gastrin level (>20-fold elevated, p = 0.022), a longer delay in diagnosis (8.1 vs 4.9 yr, respectively, p = 0.039), a prior gastric acid reducing surgical procedure (33% vs 12%, p = 0.026), to have taken histamine H2-receptor antagonists for a longer time (p = 0.064), to have a history of heartburn/GERD (p = 0.065), and to have a higher MAO (p = 0.059).