[Open acess to endoscopy in a tertiary referal center]

Abstract

Objective: The purpose of this study was to determine the yield of open access endoscopy in a third level Mexican hospital.

Background data: Open access endoscopy is common in United States of America and Europe (endoscopy is performed without prior specialist consultation). In Mexico this system hasn't become popular yet. The usefulness of open access endoscopy has been questioned. Some indications for upper gastrointestinal endoscopy (UGE) aren't included in the guidelines for appropriate use of endoscopy.

Method: All patients referred to diagnostic UGE in our hospital were admitted during a period of 30 days. The indications of UGE were analyzed by means the American Society of Gastrointestinal Endoscopy (ASGE) guidelines for the appropriate use of upper gastrointestinal endoscopy. Relevant findings were analyzed to all UGE performed in the study.

Results: The mean age of the 208 patients studied was 52.5 years; 169 UGE (81.2%) were appropriated according to the ASGE guidelines. Seventy-five percent of appropriate UGE had relevant findings compared with 59% of inappropriate UGE (p < 0.05). There wasn't difference when compared the rate of relevant findings in appropriate UGE (75%) with 72% in all UEG performed. Ten patients had indications that didn't fit in the ASGE guidelines.

Conclusions: The appropriate EGDs have more relevant findings but the inappropriate EGDs have an important number of relevant findings too. The ASGE guidelines are not always suitable for all patients. This study supports the usefulness of open acces endoscopy.