Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 28, 2010; 16(20): 2520-2525
Published online May 28, 2010. doi: 10.3748/wjg.v16.i20.2520
Rate and yield of repeat upper endoscopy in patients with dyspepsia
Uri Ladabaum, Viam Dinh
Uri Ladabaum, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Redwood City, CA 94063, United States
Viam Dinh, Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA 94143, United States
Author contributions: Ladabaum U and Dinh V designed and performed the research, analyzed the data and wrote the paper.
Correspondence to: Uri Ladabaum, MD, MS, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, 450 Broadway Street, Pavilion C 4th Floor MC: 6341, Redwood City, CA 94063, United States. uri.ladabaum@stanford.edu
Telephone: +1-650-7217217 Fax: +1-650-7213471
Received: January 22, 2010
Revised: February 14, 2010
Accepted: February 21, 2010
Published online: May 28, 2010
Abstract

AIM: To determine the rate and yield of repeat esophagogastroduodenoscopy (EGD) for dyspepsia in clinical practice, whether second opinions drive its use, and whether it is performed at the expense of colorectal cancer screening.

METHODS: We performed a retrospective cohort study of all patients who underwent repeat EGD for dyspepsia from 1996 to 2006 at the University of California, San Francisco endoscopy service.

RESULTS: Of 24 780 EGDs, 5460 (22%) were performed for dyspepsia in 4873 patients. Of these, 451 patients (9.3%) underwent repeat EGD for dyspepsia at a median 1.7 (interquartile range, 0.8-3.1) years after initial EGD. Significant findings possibly related to dyspepsia were more likely at initial (29%) vs repeat EGD (18%) [odds ratio (OR), 1.45; 95% confidence interval (CI): 1.20-1.75, P < 0.0001], and at repeat EGD if the initial EGD had reported such findings (26%) than if it had not (14%) (OR, 1.32; 95% CI: 1.08-1.62, P = 0.0015). The same endoscopist performed the repeat and initial EGD in 77% of cases. Of patients aged 50 years or older, 286/311 (92%) underwent lower endoscopy.

CONCLUSION: Repeat EGD for dyspepsia occurred at a low but substantial rate, with lower yield than initial EGD. Optimizing endoscopy use remains a public health priority.

Keywords: Dyspepsia, Esophagogastroduodenoscopy, Health resources, Diagnostic techniques and procedures, Repeat, Treatment outcome