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. 2025 Dec 16;17(12):110842.
doi: 10.4253/wjge.v17.i12.110842.

Impact of referral delays on dysphagia outcomes in a Saudi tertiary center

Khaled M AlQahtani  1 , Abdulkreem A AlNasser  1 , Ali M AlQahtani  1 , Abdulaziz A AlTurki  2 , Aseel K Aljaili  2 , Abdulkhaleq H Alamri  2 , Ali S Owayed  2 , Yasser W Asiri  2 , Shakir A Bakkari  1 , Ameen M Jaddoh  1 , Thamer A Aldarsouny  1 , Toufic G Semaan  1 , Mohamed S Elbayoumy  1 , Ibrahim M Alruzug  1 , Alhumidi A Alenezi  1 , Mohammed S Bin-Ofaysan  1 , Mohammed O Alsager  1 , Hatim S Alshahrani  1 , Sultan M Alhaddad  1 , Hisham N Almuhayzi  1 , Rana A Almousa  1 , Awad J Shehada  1 , Adnan A AlMasri  1 , Manhal K Aldaher  1 , Mostafa E Maaly  1 , Ihab M Hafez  1 , Saeed R Alzubide  3
Affiliations

Impact of referral delays on dysphagia outcomes in a Saudi tertiary center

Khaled M AlQahtani et al. World J Gastrointest Endosc. .

Abstract

Background: Dysphagia requires prompt evaluation but data regarding referral-to-assessment intervals and its association with outcomes in tertiary care are scarce, especially in Saudi Arabia.

Aim: To investigate the assessment and outcome of consecutive dysphagia referrals to a tertiary gastroenterology practice.

Methods: This retrospective single-center study analyzed 207 consecutive dysphagia referrals to King Saud Medical City (2022-2023). Data collection included referral timelines, diagnostic investigations, etiologies and outcomes. Statistical Package for the Social Sciences version 28.0, employing χ 2 tests and analysis of variance, with P < 0.05 considered statistically significant.

Results: Total 168 patients included in this study (mean age 45.7 ± 17.7 years, 50% male), referral delays > 2 weeks occurred in 44% for clinical assessment and 50% for endoscopy. Gastroesophageal reflux disease was most common (45.2%), followed by eosinophilic esophagitis (14.8%) and malignancy (6.5%). Patients receiving endoscopy within 2 weeks showed an 84.6% improvement, compared to 76.0% with delayed referral (P = 0.012). All malignant cases were referred within 2 weeks, compared to 52.7% of non-malignant cases (P = 0.013). However, 67% of the malignant cases worsened, and 33% died.

Conclusion: Early endoscopy within 2 weeks provides significant benefit. Optimised management of dysphagia should consist of more direct referral pathways.

Keywords: Dysphagia; Endoscopy; Gastroesophageal reflux disease; Malignancy; Referral timelines; Saudi Arabia; Tertiary care.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest related to this work.

Figures

Figure 1
Figure 1
Patient flow chart showing selection criteria, exclusions, diagnostic workup, and outcomes for dysphagia referrals to King Saud Medical City gastroenterology department (2022-2023). GERD: Gastroesophageal reflux disease.
Figure 2
Figure 2
Etiology and outcome of cases of dysphagia, King Saud Medical City, Riyadh (2022-2023). A: Etiology of dysphagia; B: Outcome of cases. GERD: Gastroesophageal reflux disease.
See this image and copyright information in PMC

References

    1. Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR, Locke GR 3rd, Talley NJ. Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil. 2015;27:212–219. - PMC - PubMed
    1. Malagelada JR, Bazzoli F, Boeckxstaens G, De Looze D, Fried M, Kahrilas P, Lindberg G, Malfertheiner P, Salis G, Sharma P, Sifrim D, Vakil N, Le Mair A. World gastroenterology organisation global guidelines: dysphagia--global guidelines and cascades update September 2014. J Clin Gastroenterol. 2015;49:370–378. - PubMed
    1. Cockeram AW. Canadian Association of Gastroenterology Practice Guidelines: evaluation of dysphagia. Can J Gastroenterol. 1998;12:409–413. - PubMed
    1. Ferreira DC, Vieira I, Pedro MI, Caldas P, Varela M. Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare (Basel) 2023;11:639. - PMC - PubMed
    1. Trudgill NJ, Sifrim D, Sweis R, Fullard M, Basu K, McCord M, Booth M, Hayman J, Boeckxstaens G, Johnston BT, Ager N, De Caestecker J. British Society of Gastroenterology guidelines for oesophageal manometry and oesophageal reflux monitoring. Gut. 2019;68:1731–1750. - PMC - PubMed

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