Inappropriateness rate for colonoscopy indications in an open access unit

Inappropriateness rate for colonoscopy indications in an open access unit

The suitability of indications for colonoscopy is important to optimize the available resources. The aim of this study was to assess the appropriateness of colonoscopy indications in an open access endoscopy unit using the EPAGE II criteria. Colonoscopies performed between October 1 and November 30,...

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Bibliographic Details
Published in:Gastroenterología y hepatología Vol. 38; no. 5; p. 313
Main Authors: Andújar, Xavier, Sainz, Empar, Galí, Alex, Loras, Carme, Aceituno, Montserrat, Espinós, Jorge C, Viver, Josep M, Esteve, Maria, Fernández-Bañares, Fernando
Format: Journal Article
Language:Spanish
Published: Spain 01-05-2015
Subjects:
Adult
Age Factors
Aged
Colonic Polyps - diagnosis
Colonic Polyps - surgery
Colonoscopy - utilization
Female
Humans
Inflammatory Bowel Diseases - diagnosis
Male
Middle Aged
Practice Guidelines as Topic
Referral and Consultation - statistics & numerical data
Retrospective Studies
Sex Factors
Unnecessary Procedures - statistics & numerical data
Colonoscopia
Open access unit
Unidad de acceso abierto
EPAGE II
Colonoscopy
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Summary:The suitability of indications for colonoscopy is important to optimize the available resources. The aim of this study was to assess the appropriateness of colonoscopy indications in an open access endoscopy unit using the EPAGE II criteria. Colonoscopies performed between October 1 and November 30, 2011 were retrospectively included. The appropriateness of the colonoscopy was established according to the EPAGE II criteria. Demographics, medical applicants, indications and relevant findings from these examinations were recorded. We included 440 colonoscopies (60.8 ± 016.3 years, 54% women). The indication was appropriate in 75.4% (CI, 71-79.3%), uncertain in 13.1% (CI, 10.2-16.6%) and inappropriate in 11.4% (CI, 8.7-14.8%). In the univariate analysis, the relevant findings in the colonoscopy were associated with age, sex, colonoscopy indications and EPAGE II. In the logistic regression analysis, factors independently associated with the presence of relevant findings were age (≥ 50 years) (OR, 1.84), male sex (OR, 2.7) and two indications, inflammatory bowel disease and post-polypectomy surveillance (P < .03). The diagnostic yield of EPAGE II criteria was 37.3% for appropriate colonoscopies and 28.3% for inappropriate colonoscopies (P = .09). The rate of unnecessary colonoscopy is high, especially in young patients (<50 years) and some colonoscopy indications. Age (≥ 50 years) and male sex are independently associated with the presence of relevant findings in colonoscopy. The diagnostic yield of EPAGE II criteria does not differ between appropriate and inappropriate examinations.
ISSN:0210-5705
DOI:10.1016/j.gastrohep.2014.11.003