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Outpatient upper gastrointestinal endoscopy: large, prospective study of the morbidity and mortality rate at a single endoscopy unit in England
Author(s) -
Abbas Syed Z,
Shaw Steve,
Campbell Diane,
George David K,
Lowes John R,
Teague Robin H
Publication year - 2004
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.2003.00322.x
Subject(s) - medicine , sedation , premedication , endoscopy , prospective cohort study , midazolam , esophagogastroduodenoscopy , pediatrics , surgery
Background: There are few prospective studies that look at the standards of the practice of esophago‐gastroduodenoscopy (EGD) and its associated morbidity. Patients and methods: Data were recorded prospectively for 1287 consecutive day‐case diagnostic EGD procedures. Thirty days later, 1155 of 1287 patients were successfully contacted. Results: The standards of care, as per various national recommendations, were met. Seven hundred and fifty‐four patients (401/572 [70%] men; 353/715 [49%] women; P = 0.001) chose pharyngeal anesthesis (PA) as premedication. Two women had general anesthesia. There were no immediate clinical complications. Thirty days later, 119/1155 (10%) patients who were contacted reported a problem, one requiring hospital admission. Fifty‐one of 119 had EGD performed under midazolam sedation (MS). Twenty‐five of 119 patients required consultation with a health‐care professional. No death occurred. Seventy‐nine percent of patients contacted who underwent their procedure with PA compared with 95% who had MS, said they would prefer the same premedication if EGD was required again in the future ( P = 0.001). In subjects who had PA, 25% of women and 12% of men said they would prefer MS if EGD were required again ( P = 0.001). Conclusions: Diagnostic EGD is a safe procedure, but carries a small complication rate. Patients’ gender, age, or patients’ preference for sedation or endoscopist did not affect the morbidity rate. Although the majority, particularly men, chose to have EGD performed unsedated, a significant number, particularly women, would prefer MS if EGD was required again.