What Are Outcomes Following Ambulatory Endoscopy Procedures?

Walid M Hesham, MD, Peter W Marcello, MD, Patricia L Roberts, MD, Thomas E Read, MD, David J Schoetz, MD, Rocco Ricciardi, MD. Lahey Clinic

What Are The Outcomes Of Ambulatory Endoscopy Procedures?

Introduction: Despite high volumes of ambulatory endoscopy procedures performed, acceptable measures of post endoscopy outcome are lacking. Our aim was to identify major complications and patient complaints following outpatient endoscopy at ambulatory care facilities in the U.S.

Methods: Data were retrieved from the 2006 National Survey of Ambulatory Surgery (NSAS) study conducted by the Centers for Disease Control. Multivariate models were developed to identify predictors of major complications, patient complaints, and likelihood of seeking further medical care, while accounting for patient sex, facility location, facility type, procedure type, number of procedures, payer, and anesthesia used.

Results: Of the 52,233 ambulatory surgical patients in the 2006 NSAS database, 10,047 patients had endoscopy procedures (6,866 lower and 3,181 upper endoscopies). Major complications, such as perforation or bleeding, were reported in 14 patients (0.1%). Follow-up data were available for 4,878 (48.6%) patients. From the cohort with complete follow-up information, patient complaints were reported in 313 (6.4%). Of the patients with complaints, 60 (19.2%) sought further medical care. On multivariate analysis, female patients were more likely to have post endoscopy complaints {Odds Ratio (OR) 1.48; Confidence Interval (CI) 1.13-1.93} and to seek further medical care (OR 1.92; CI 1.02-3.61). Patients were also more likely to have complaints post endoscopy if their procedure was performed at a freestanding facility (OR 2.40; CI 1.43-4.01) as compared to a hospital based facility, or if they underwent endoscopy in a metropolitan area (OR 2.09; CI 1.22-3.58) compared to a nonmetropolitan area. Patients who did not have general anesthesia (OR 0.38; CI 0.28-0.52) were also less likely to have complaints as compared to patients undergoing other forms of anesthesia.

Conclusions: Although few major complications occur immediately following endoscopy at ambulatory care facilities throughout the United States, post endoscopy complaints requiring further medical care are not uncommon. Female patients and those who have their procedure in a freestanding facility or a metropolitan area were more likely to have complaints while patients who did not receive general anesthesia reported fewer complaints. Additional studies are needed to address factors that lead high-risk patients to seek further medical care after endoscopic procedures.

Session: Poster
Program Number: P208
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