Appropriateness of Indications of Upper Gastrointestinal Endoscopy and its Association With Positive Finding

Journal of Nepal Medical Association

article

Tanka Prasad Bohara¹  Uttam Laudari¹  Abishek Thapa¹  Shail Rupakheti¹  Mukund Raj Joshi¹ 

[1]Department of Surgery, Kathmandu Medical College Teaching Hospital

关键词: appropriateness;    endoscopy;    guidelines;    indications.;   

DOI  :  10.31729/jnma.3121

学科分类：社会科学、人文和艺术（综合）

来源: Nepal Medical Association since

【 摘 要 】

Introduction:  Upper Gastrointestinal Endoscopy(UGIE) is a frequently advised investigation for upper abdominal symptoms. Studies have questioned the appropriateness of indications for UGIE and have shown that inappropriate indications range from 5% to 49%. The unnecessary UGIE expose patients to the risk. The number of UGIE is rising in our region and we assume so is the number of unnecessary UGIE. With an aim to evaluate the appropriateness of the indications of UGIE and compare its association with positive findings, we conducted a cross-sectional descriptive study. Methods: All patients undergoing diagnostic UGIE during the study period were included in the study. Appropriateness of indications for UGIE was defined as per American Society for Gastrointestinal Endoscopy(ASGE) criteria as “appropriate” and “inappropriate”. UGIE endoscopy findings were classified as “significant” and “insignificant” based on endoscopy findings. The extent of this association between the appropriateness of indications and UGIE findings was expressed as the odds ratio (OR) of finding a relevant diagnosis in patients with an ‘‘appropriate’’ indication compared with those with an ‘inappropriate’’ indication. Results: Seventy-nine patients were included in the study. Fifty- two (65.8 %) of the indications were considered appropriate as per ASGE guidelines. Thirty-three (63.5%) of the appropriate indications has clinically significant finding as compared to seven (25.9%) of inappropriate indication with an odds ratio of 4.962 (95%CI:1.773 – 13.890, p=0.002) which is statistically significant. Conclusions:  Appropriate indications have significantly higher rates of clinically significant findings. Use of guidelines may decrease the number of unnecessary procedures.

【 授权许可】

CC BY