PDF(Pubmed)
Abstract：
UNASSIGNED: Dyspepsia is a common, generally low-risk gastrointestinal condition. The American College of Gastroenterology and Canadian Association of Gastroenterology recommend avoiding gastroscopy in healthy patients <60 years old. Many dyspeptic patients can be effectively managed in primary care. This study aimed to determine: (1) the proportion of gastroscopies performed for dyspepsia among patients <65 years old with no alarm symptoms or clinically appropriate indications and (2) to determine the frequency of clinically actionable findings and dyspepsia-related healthcare utilization in the year following gastroscopy.
UNASSIGNED: Outpatient endoscopy reports were sampled and reviewed retrospectively from 2019 to -2021 in Edmonton, Alberta to identify gastroscopies performed for the indication of dyspepsia. Gastroscopies were considered low-risk for significant endoscopic findings if age <65, no alarm symptoms or other concerning indications, and insufficient evidence that first-line treatments and diagnostic approaches had been tried prior to gastroscopy. Clinically important findings were defined as those impacting management, not otherwise identifiable non-invasively.
UNASSIGNED: Of the 358 reviewed gastroscopies for dyspepsia, 293 (81.8%) had no alarm symptoms, and 130 (36.3%) had no alarm symptoms or other appropriate indications. Clinically important findings were identified in 9 (6.9%) of the 130 low-risk cases. In the year following, one patient (1/130) visited the emergency department 3 times for their symptoms and no patients required hospital admission. No malignancies were detected.
UNASSIGNED: Many gastroscopies are performed on patients <65 years old with dyspepsia, even when they lack alarm symptoms or other clinical indications, despite recommendations against this practice and low procedure yield. Strategies to improve the uptake of current guidelines may optimize endoscopy resource utilization.
UNASSIGNED: Outpatient endoscopy reports were sampled and reviewed retrospectively from 2019 to -2021 in Edmonton, Alberta to identify gastroscopies performed for the indication of dyspepsia. Gastroscopies were considered low-risk for significant endoscopic findings if age <65, no alarm symptoms or other concerning indications, and insufficient evidence that first-line treatments and diagnostic approaches had been tried prior to gastroscopy. Clinically important findings were defined as those impacting management, not otherwise identifiable non-invasively.
UNASSIGNED: Of the 358 reviewed gastroscopies for dyspepsia, 293 (81.8%) had no alarm symptoms, and 130 (36.3%) had no alarm symptoms or other appropriate indications. Clinically important findings were identified in 9 (6.9%) of the 130 low-risk cases. In the year following, one patient (1/130) visited the emergency department 3 times for their symptoms and no patients required hospital admission. No malignancies were detected.
UNASSIGNED: Many gastroscopies are performed on patients <65 years old with dyspepsia, even when they lack alarm symptoms or other clinical indications, despite recommendations against this practice and low procedure yield. Strategies to improve the uptake of current guidelines may optimize endoscopy resource utilization.
摘要：
■消化不良是常见的，通常是低风险的胃肠道疾病。美国胃肠病学学会和加拿大胃肠病学协会建议在60岁以下的健康患者中避免胃镜检查。许多消化不良患者可以在初级保健中得到有效管理。本研究旨在确定：（1）在65岁以下无警报症状或临床适当适应症的患者中进行消化不良的胃镜检查的比例；（2）确定临床可行的发现和消化不良相关的医疗保健利用的频率。胃镜检查后的一年。
■从2019年至2021年在埃德蒙顿对门诊内窥镜检查报告进行了采样和回顾性审查，艾伯塔省确定为消化不良指征而进行的胃镜检查。如果年龄<65岁，没有警报症状或其他相关适应症，胃镜检查被认为是重大内镜检查结果的低风险。以及在胃镜检查前尝试过一线治疗和诊断方法的证据不足.临床上重要的发现被定义为影响管理的发现，没有其他可识别的非侵入性。
■在358例消化不良的胃镜检查中，293人(81.8%)没有报警症状，和130（36.3％）没有警报症状或其他适当的适应症。在130例低风险病例中，有9例（6.9％）发现了临床重要的发现。第二年,1例患者(1/130)因症状到急诊科就诊3次,无患者需要入院.未检测到恶性肿瘤。
■许多胃镜检查是对<65岁的消化不良患者进行的，即使他们缺乏警报症状或其他临床适应症，尽管建议反对这种做法和低程序产量。改善当前指南吸收的策略可能会优化内窥镜检查资源的利用。
■从2019年至2021年在埃德蒙顿对门诊内窥镜检查报告进行了采样和回顾性审查，艾伯塔省确定为消化不良指征而进行的胃镜检查。如果年龄<65岁，没有警报症状或其他相关适应症，胃镜检查被认为是重大内镜检查结果的低风险。以及在胃镜检查前尝试过一线治疗和诊断方法的证据不足.临床上重要的发现被定义为影响管理的发现，没有其他可识别的非侵入性。
■在358例消化不良的胃镜检查中，293人(81.8%)没有报警症状，和130（36.3％）没有警报症状或其他适当的适应症。在130例低风险病例中，有9例（6.9％）发现了临床重要的发现。第二年,1例患者(1/130)因症状到急诊科就诊3次,无患者需要入院.未检测到恶性肿瘤。
■许多胃镜检查是对<65岁的消化不良患者进行的，即使他们缺乏警报症状或其他临床适应症，尽管建议反对这种做法和低程序产量。改善当前指南吸收的策略可能会优化内窥镜检查资源的利用。
