Endoscopy audit over 10 years in a community hospital in Egypt

Abstract

Background: Practice variation is likely to have an important impact on the effectiveness of endoscopy. Performing regular quality audits allows identification of potential underperformance and consequently can result in significant improvement in endoscopy quality. An annual audit was conducted in a community hospital in Egypt. Aim: The aim of the study was to determine if practice and performance of endoscopy is influenced by a consistent audit process by looking for improvement in completeness of procedures over a 10-year period. Patients and methods: A total of 3736 consecutive procedures were prospectively assessed between years 2004 and 2014. Results: The completion rates improved consistently. Esophagogastroduodenoscopy (EGD) completion rate was 99.

Significance of Endoscopyic Findings in Patients with Dyspepsia in Diyala Province - Iraq Hospital Based Study

“…In this study normal endoscopy was more common in dyspeptic patients younger than 55 years with alarm symptoms compared to patients older than 55 years (42% vs 30%) while clinically significant endoscopic findings were more common in patients older than 55 years (70% vs 58%).These findings are consistent with previous sudies of Saba Fakhrieh et al [3], AB Thomson etal [12], Ahmed Gado et al (18), Lopez LH et al [14] and Sanjiv M et al [26] while Wallace MB et al [25] reported that age and sex were significant but weak independent predictors of endoscopic findings. Regarding sex distribution, normal endoscopic finding was more common in female patients (42.47% vs 36.17%) while clinically significant endoscopic findings found more in male patients (63.83% vs 57.53%), these results go with studies of Jung HK et al [22] and Sanjiv M et al [26] revealed that male gender increased the risk for having endoscopic abnormality.…”

“…The most common clinically significant endoscopic findings in this study were duodenal ulcer in 18.33% of patients followed by gastritis in 14.17% and esophagitis in 10.33%. Ahmed Gado et al [18] revealed that duodenal ulcer was the most common finding in 15% of patients follwed by esophagitis in 14% then gastritis in 4%. Sumathi B etal [6] showed that duodenal ulcer was the most common finding in 10.9% followed by esophagitis in 5.1%.In the study of Piatek -Guziewicz A et al [27] gastritis was the most common endoscopic lesion followed by esophagitis then peptic ulcer.Vasilliou C [28] showed that chronic gastritis followed by hiatus hernia were most prevalent.AB Thomson et al [12] showed that esophagitis was the most common finding in 43.4% while Ghamar Chehreh et al [1] revealed that the most common finding was gastritis.…”

“…in the study of Alexander C et al [15] (0.4%) of dyspeptic patient had gastic cancer while Ghamar Chehreh et al [1] showed that the prevalence of gastric cancer was (5%) and esophageal cancer (2.5%). Sumathi B [6] , Salkic et al [8], Hye-Kyung Jung [12] and Ahmed Gado et al [18] revealed that the overall malignancy rates were 3.5%, 1.86%, 1.3% and 1% respectively. The high prevalence of gastric cancer in some studies is due to the fact that the prevalence of gastric cancer is high in some populations as in Southeast Asia [32].…”

“…An organic cause is found in 40% of patients with dyspeptic symptoms [4,11,17,18]. In others, no cause is identified and the dyspepsia is considered to be functional or non-ulcer dyspepsia [11,19,21].Clinical impression, demographics, risk factors, patient history and symptoms are non specific for differentiating between structural from functional dyspepsia [9,13,22].…”

“…Options for evaluating dyspeptic patients include therapeutic trials, testing and eradication for H. pylori, upper GI radiography and endoscopy [4,9,18].Dyspeptic symptoms are the most frequent reason for requesting for an upper endoscopy [6] and endoscopy is the gold standard in evaluating dyspeptic patients [1,23] because of its ease, reliability, diagnostic superiority and the ability to perform biopsies and /or therapeutic interventions [23].A negative endoscopy may have a significant reassuring effect and may result in a decreased use of medication , in a fewer medical consultations [3],reduction in anxiety and an increase in patient satisfaction [9] however, it is associated with a certain degree of discomfort, inconvenience, cost and low availability in some areas [8]. Guidelines have been drawn by various associations to make the use of upper gastro-intestinal endoscopy more rational [6] as the establishment of this procedure for every dyspeptic patient may not be a practical approach because it has burdensome expenses on health system […”