Esophagogastroduodenoscopy Indications: Are We Following the New Guidelines?

Soyka, Caroline; Tripathi, Priyam; Cooper, Gregory S.

doi:10.14309/00000434-201410002-02235

Cited by 1 publication

(2 citation statements)

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“…Medical inpatients frequently require endoscopy for non‐bleeding indications, including ruling out malignancy, working up abdominal pain, screening for varices in cirrhosis, assessing gastroduodenal ulcers and masses, diagnosing inflammatory bowel disease and in managing chronic diarrhea 30–33 . Further, 10% to 40% of inpatient endoscopies have been deemed inappropriate as per clinical practice guidelines 34 . There is limited prior research defining a high‐risk subset of patients undergoing these procedures.…”

Section: Discussionmentioning

confidence: 99%

“…[30][31][32][33] Further, 10% to 40% of inpatient endoscopies have been deemed inappropriate as per clinical practice guidelines. 34 There is limited prior research defining a high-risk subset of patients undergoing these procedures. Our study demonstrated that early upper endoscopy procedures, particularly in patients with kidney injury (elevated creatinine), and those with comorbid disease may portend high risk of ICU admission or death.…”

Section: Icu Admission After Inpatient Endoscopymentioning

confidence: 99%

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Predictors of ICU admission associated with gastrointestinal endoscopy in medical inpatients: A retrospective cohort study

Sankar

Ladha

Grover

et al. 2022

J of Gastro and Hepatol

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Background and Aim Gastrointestinal (GI) endoscopic procedures are commonly performed in medical inpatients. Limited prior research has examined factors associated with intensive care unit (ICU) admission after GI endoscopy in medical inpatients. Methods This retrospective cohort study was conducted using routinely‐collected clinical and administrative data from all general medicine hospitalizations at five academic hospitals in Toronto, Canada between 2010 and 2020. We describe ICU admission and death within 48 h of GI endoscopy in medical inpatients. We examined adjusted associations of patient and procedural factors with ICU admission or death using multivariable logistic regression. Results Among 18 290 medical inpatients who underwent endoscopy, 900 (4.9%) required ICU admission or died within 48 h of endoscopy. Following risk adjustment, ICU admission or death were associated with the following procedural factors: endoscopy on the day of hospital admission (aOR 3.16 [2.38–4.21]) or 1 day after admission (aOR 1.92 [1.51–2.44]) and esophagogastroduodenoscopy (EGD) procedures; and the following patient factors: Charlson comorbidity index of two (aOR 1.38 [1.05–1.81]) or three or greater (aOR 1.84 [1.47–2.29]), older age, male sex, lower hemoglobin prior to endoscopy, increased creatinine prior to endoscopy, an admitting diagnosis of liver disease and certain medications (antiplatelet agents and corticosteroids). Conclusions ICU admission or death after endoscopy was associated with procedural factors such as EGD and timing of endoscopy, and patient factors indicative of acute illness and greater comorbidity. These findings can contribute to improved triage and monitoring for patients requiring inpatient endoscopy.

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Section: Discussionmentioning

confidence: 99%