Adverse events of upper GI endoscopy

Ben–Menachem, Tamir; Decker, G. Anton; Early, Dayna S.; Evans, Jerry; Fanelli, Robert D.; Fisher, Deborah A.; Fisher, Laurel; Fukami, Norio; Hwang, Joo Ha; Ikenberry, Steven O.; Jain, Rajeev; Jue, Terry L.; Khan, Khalid; Krinsky, Mary Lee; Malpas, Phyllis M.; Maple, John T.; Sharaf, Ravi; Dominitz, Jason A.; Cash, Brooks D.

doi:10.1016/j.gie.2012.03.252

Cited by 316 publications

(199 citation statements)

References 230 publications

(298 reference statements)

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“…Endoscopy can also diagnose esophageal adenocarcinoma, which has been increasing rapidly in North America although there is now evidence that the rising incidence is reaching a plateau ( 24 ). While endoscopy is the gold standard test for diagnosing malignancy, it is expensive and invasive with a small risk of serious morbidity and mortality ( 25,26 ). All guidelines have therefore recommended alternative approaches for management of dyspepsia in patients with low risk of malignancy.…”

Section: Conditional Recommendation Very Low Quality Evidencementioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

508

520

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Section: Conditional Recommendation Very Low Quality Evidencementioning

confidence: 99%

ACG and CAG Clinical Guideline: Management of Dyspepsia

Martin

Lacy

Andrews

et al. 2017

American Journal of Gastroenterology

508

520

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“…30 Notwithstanding, older patients are at particularly higher risk of developing endoscopy-related adverse events 5,20,25 and nosocomial pneumonia. 26 The results of this retrospective observational study provide evidence that patients of at least 65 years of age have an increased risk of developing LRI and pneumonia after GIES.…”

Section: Discussionmentioning

confidence: 99%

“…In Germany, for instance, where a routine colonoscopy screening program is implemented, the number of EGDs exceeds that of colonoscopies by nearly twofold. 3 More than 90% of gastrointestinal endoscopies are performed under sedation [4][5][6][7][8] to reduce the patient's anxiety, pain and inconvenient experiences, as well as improving its quality and outcome. 4,[9][10][11][12] Therefore, in addition to common risks associated with gastrointestinal endoscopy itself, such as perforation, bleeding and abdominal discomfort, 1,[13][14][15] adverse events related to sedation have to be considered, 16,17 among which cardiovascular and pulmonary events predominate.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal endoscopy under sedation is associated with pneumonia in older inpatients—results of a retrospective case-control study

Kollmann

Schmiegel

Brechmann

2017

United European Gastroenterology Journal

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Background and aims: Apparent aspiration is a notable adverse event during gastrointestinal endoscopy under sedation (GIES), but data about inapparent aspiration are scarce. Generally, particularly older patients are at higher risk of suffering from adverse events. Objective: The objective of this article is to determine the risk of pneumonia, lower respiratory tract infection (LRI) and systemic inflammatory activation after GIES, especially in patients of at least 65 years. Methods: The retrospective case-control study included 250 patients undergoing GIES and assigned age-, gender-and time of performance-matched controls without invasive procedure or sedation (ratio 1:1). Results: On day 3 patients of advanced age presented with both pneumonia and LRI more often (2.6 vs. 0.0%, p ¼ 0.041 and 7.8 vs. 2.5%, p ¼ 0.034, respectively). In general, several inflammatory parameters increased significantly after GIES (i.e. white blood cell count (increase of ! 25%) 18.6 vs. 6.9%, p < 0.001), leading to more frequent antibiotic treatment (6.8 vs. 1.6%, p ¼ 0.004). The effects were less pronounced on day 7. Conclusions: Patients of advanced age carry an increased risk of pneumonia and LRI after GIES. Patients are generally more likely to feature inflammation and to receive antibiotic treatment.

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“…Although diagnostic colonoscopy has a very real perforation rate [11, 12], upper endoscopy is widely assumed to be a safer procedure because the scope must traverse a shorter distance with far less angulation or looping [13-15]. Conscious sedation for any procedure may entail its own set of risks including oversedation, aspiration, and medication reaction [16, 17].…”

Section: Discussionmentioning

confidence: 99%

Absence of Complications after Endoscopic Mucosal Biopsy

Johnson¹,

Basson²

2018

Dig Dis

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Background: There is no clarity with regard to the occurrence of serious complications from EGD-driven mucosal biopsy. This is important for considering both clinically indicated procedures and mucosal sampling for research. Methods: We sought to quantify rates of serious complications from esophagogastroduodenoscopy (EGD) with biopsy. We studied 13,233 patients undergoing outpatient EGD with biopsy over 5 years in 2 North Dakota community hospitals, based on the reasoning that serious complications would cause hospitalization within 30 days. We reviewed the records of all patients with a diagnostic or procedure code or admission within 30 days after the outpatient EGD with biopsy. Results: Of the 13,233 patients who underwent outpatient EGD with biopsy, 411 were admitted within 30 days, most of them because of their underlying diagnosis. Two patients were admitted due to complications that resulted because of additional simultaneous procedures. No patient was admitted because of complications that could be ascribed to conscious sedation, upper GI endoscopic access, or mucosal biopsy. Conclusions: These data confirm that EGD biopsy is safe within community settings and suggest that the risk/benefit ratio for performing EGD biopsy for research is likely to be favorable if the research has scientific merit. Serious complications or perforation following EGD biopsy did not occur in 13,233 patients in community hospitals in North Dakota.

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Adverse events of upper GI endoscopy

Cited by 316 publications

References 230 publications

ACG and CAG Clinical Guideline: Management of Dyspepsia

ACG and CAG Clinical Guideline: Management of Dyspepsia

Gastrointestinal endoscopy under sedation is associated with pneumonia in older inpatients—results of a retrospective case-control study

Absence of Complications after Endoscopic Mucosal Biopsy

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