TY - JOUR
T1 - Open access endoscopy
T2 - A large-scale analysis of its use in dyspeptic patients
AU - Mansi, Carlo
AU - Mela, Giuseppe Sandro
AU - Savarino, Vincenzo
AU - Mele, Maria Raffaella
AU - Valle, Francesca
AU - Celle, Guido
PY - 1993
Y1 - 1993
N2 - We examined 2,253 consecutive dyspeptic patients referred to our endoscopy service by general practitioners (“open” group) and hospital clinicians (“clinic” group) to study the prevalence of the various endoscopic findings according to patient age and the route of endoscopic referral. The results obtained are representative of that specific population. Normal endoscopic findings progressively lessened as patients' age increased, and the overall rate was as low as 26.5% in the open and 30.3% in the clinic groups. Erosive prepyloric changes and duodenitis were the most frequently noted abnormalities in patients <40 years of age (16.9% and 20.1%, respectively, in the open and 11.6% and 14.2% in the clinic groups). Chronic gastritis was prevalent in patients > 60 years of age. Duodenal ulcer decreased from 9.7% (open) and 18% (clinic) in patients <40 to 2% and 1.1% in patients > 60. No malignancy was found in patients <40, while only ∼1% of those <60 had neoplasms. All our endoscopic findings, both in the open and the clinic groups, were not significantly different. No significant differences in symptoms were observed among patients with different endoscopic findings. We conclude that (a) endoscopy is really useful only in a small group of patients > 40 years of age; (b) individual symptoms alone have a poorly discriminant diagnostic power; and (c) restriction of open access endoscopy is not justified.
AB - We examined 2,253 consecutive dyspeptic patients referred to our endoscopy service by general practitioners (“open” group) and hospital clinicians (“clinic” group) to study the prevalence of the various endoscopic findings according to patient age and the route of endoscopic referral. The results obtained are representative of that specific population. Normal endoscopic findings progressively lessened as patients' age increased, and the overall rate was as low as 26.5% in the open and 30.3% in the clinic groups. Erosive prepyloric changes and duodenitis were the most frequently noted abnormalities in patients <40 years of age (16.9% and 20.1%, respectively, in the open and 11.6% and 14.2% in the clinic groups). Chronic gastritis was prevalent in patients > 60 years of age. Duodenal ulcer decreased from 9.7% (open) and 18% (clinic) in patients <40 to 2% and 1.1% in patients > 60. No malignancy was found in patients <40, while only ∼1% of those <60 had neoplasms. All our endoscopic findings, both in the open and the clinic groups, were not significantly different. No significant differences in symptoms were observed among patients with different endoscopic findings. We conclude that (a) endoscopy is really useful only in a small group of patients > 40 years of age; (b) individual symptoms alone have a poorly discriminant diagnostic power; and (c) restriction of open access endoscopy is not justified.
KW - Dyspepsia
KW - Endoscopy
KW - General practice
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M3 - Article
C2 - 8463620
AN - SCOPUS:0027511693
VL - 16
SP - 149
EP - 154
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
SN - 0192-0790
IS - 2
ER -