The 30-day frequency of negative outcomes after outpatient endoscopy, performed by gastroenterology fellows is unknown.
In this study, published in the January issue of Gastrointestinal Endoscopy, researchers evaluated procedure-related negative outcomes and patient satisfaction.
|Patients who reported negative outcomes were less likely to agree to endoscopy in the future.|
The team mailed questionnaires to 1000 consecutive patients 30 days after endoscopy.
The team defined serious adverse events as oversedation requiring administration of a reversal agent, and those that resulted in a physician visit, emergency department visit, admission to the hospital, or death.
They defined minor adverse events as all problems, other than serious adverse events, that patients related to their endoscopic procedure.
The researchers found that the 30-day frequency of negative outcomes in the 869 patients who responded was 14%. Of these, 0.6% were serious and 14% were minor adverse events.
In addition, the frequency of negative outcomes was 17% for EGD, 15% for colonoscopy, 24% for combined EGD and colonoscopy, and 8% for flexible sigmoidoscopy.
The team calculated that they were aware of 100% of the serious adverse events, but only 16% of minor adverse events.
Multiple logistic regression identified midazolam dose (OR for each 1 mg increase in dose 4.5), treatment with warfarin (OR 3), comorbid disease (OR 2.1), endoscopy performed in July or August (OR 2.0), and age (OR for each 1 year increase in age 1.03) as independent predictors of negative outcomes.
The team identified a significant association between negative outcomes and decreased patient satisfaction. Furthermore, patients who reported negative outcomes were less likely to agree to endoscopy in the future.
Dr Edmund Bini's team concluded, "Serious adverse events were rare after endoscopy performed by gastroenterology fellows".
"Contacting patients 30 days after outpatient endoscopy significantly improved the detection of negative outcomes".
"Although the majority of negative outcomes were minor, these adverse events were associated with decreased patient satisfaction".