Complications of pediatric EGD: a 4-year experience in PEDS-CORI

Abstract

Background: Available estimates of the incidence and type of complications during pediatric EGD are inconsistent.

Objective: To determine the frequency and the determinants of immediate complications during EGD in children.

Design: We conducted a cross-sectional database study.

Setting: The study involved 13 pediatric facilities that use the PEDS-CORI (Pediatric Endoscopy Database System Clinical Outcomes Research Initiative).

Patients: Children (0-18 years) who underwent EGD at 13 facilities between November 1999 and December 2003.

Main outcome measurements: We identified complications (recorded shortly after the procedure) and analyzed their occurrence with respect to procedure indication, American Society of Anesthesiologists (ASA) class, sex, age, anesthesia type, and unplanned interventions.

Results: We analyzed 10,236 procedures performed in 9234 patients. Immediate complications were reported in 239 procedures (2.3%, 95% confidence interval 2.0%-2.6%). The most common complications were hypoxia (157 [1.5%]) and bleeding (28 [0.3%]). Complication rates were significantly higher in the youngest age group, highest ASA class, female gender, intravenous (IV) sedation group, and in the presence of a fellow.

Limitations: The study is limited by a lack of specific details and explicit criteria for reported complications.

Conclusions: The overall immediate complication rate of pediatric EGD is 2.3%. All complications were nonfatal, and most were hypoxia related (157/239 [66%]) and reversible. Young age, higher ASA class, female sex, and IV sedation are risk factors for developing complications.