Pitfalls in the reporting of upper endoscopy features in cirrhotic patients.
Esophageal varices
Hepatology
Portal hypertension
Survey
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
21
06
2018
revised:
08
08
2018
accepted:
10
08
2018
pubmed:
17
9
2018
medline:
19
9
2019
entrez:
17
9
2018
Statut:
ppublish
Résumé
Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients. To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice. 120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report. Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases. Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.
Sections du résumé
BACKGROUND
Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients.
AIM
To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice.
METHODS
120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report.
RESULTS
Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases.
CONCLUSION
Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.
Identifiants
pubmed: 30219669
pii: S1590-8658(18)30895-8
doi: 10.1016/j.dld.2018.08.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
382-385Informations de copyright
Published by Elsevier Ltd.