OUTPATIENT UPPER GASTROINTESTINAL ENDOSCOPY : LARGE, PROSPECTIVE STUDY OF THE MORBIDITY AND MORTALITY RATE AT A SINGLE ENDOSCOPY UNIT IN ENGLAND

Background:  There are few prospective studies that look at the standards of the practice of esophago-gastroduodenoscopy (EGD) and its associated morbidity. Patients and methods:  Data were recorded prospectively for 1287 consecutive day-case diagnostic EGD procedures. Thirty days later, 1155 of 1287 patients were successfully contacted. Results:  The standards of care, as per various national recommendations, were met. Seven hundred and fifty-four patients (401/572 [70%] men; 353/715 [49%] women; P = 0.001) chose pharyngeal anesthesis (PA) as premedication. Two women had general anesthesia. There were no immediate clinical complications. Thirty days later, 119/1155 (10%) patients who were contacted reported a problem, one requiring hospital admission. Fifty-one of 119 had EGD performed under midazolam sedation (MS). Twenty-five of 119 patients required consultation with a health-care professional. No death occurred. Seventy-nine percent of patients contacted who underwent their procedure with PA compared with 95% who had MS, said they would prefer the same premedication if EGD was required again in the future (P = 0.001). In subjects who had PA, 25% of women and 12% of men said they would prefer MS if EGD were required again (P = 0.001). Conclusions:  Diagnostic EGD is a safe procedure, but carries a small complication rate. Patients’ gender, age, or patients’ preference for sedation or endoscopist did not affect the morbidity rate. Although the majority, particularly men, chose to have EGD performed unsedated, a significant number, particularly women, would prefer MS if EGD was required again.