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Endoscopy outcomes in community hospital vs tertiary academic center settings

The most recent issue of the Digestive Diseases & Sciences compares endoscopic ultrasound based on community hospital versus tertiary academic center settings.

News image

Endoscopic ultrasound (EUS) is an established tool in the management of gastrointestinal diseases.

The majority of EUS procedures are performed in tertiary care hospitals but the technology has also disseminated to community hospitals.

The data from community hospitals are limited and there are no published studies comparing EUS-fine needle aspiration (FNA) outcomes in community versus tertiary settings.

Dr Shailendra Singh and colleagues compared EUS procedures performed in these 2 separate settings.

EUS procedures performed for pancreatobiliary indications in an academic tertiary care hospital, and a community hospital were retrospectively reviewed and compared.

Overall odds of having an unsatisfactory specimen were not significantly different at the 2 centers
Digestive Diseases & Sciences

The patient demographics, procedure time, procedure indications, FNA performed, pass counts, needle size, rapid onsite evaluation (ROSE) and final cytological diagnosis were compared between the two centers.

Cytological diagnosis was categorized as satisfactory and unsatisfactory samples.

The research team found no significant difference in patient age, gender, indications, procedure time, FNA performed, needle size, or pass counts between the tertiary hospital and community hospital.

The researchers found that ROSE was a significant determinant factor for adequacy of sample.

The team observed a positive linear relationship between adequacy of the sample and number of pass counts.

After performing a logistic regression and adjusting for target site, the overall odds of having an unsatisfactory specimen were not significantly different at the 2 centers.

Percentages of unsatisfactory samples were not significantly different at the 2 centers for solid lesions, cysts or lymph nodes.

Dr Singh's team concludes, "Cytological yield of EUS-FNA in a community hospital is similar to that of a tertiary hospital."

"Community hospitals can provide EUS services with reasonable success."

Dig Dis Sci 2014: 59(8): 1925-1930
27 August 2014

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