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DOI: 10.1055/s-0038-1637585
APPROPRIATENESS OF COLONOSCOPY INDICATIONS ACCORDING TO THE NEW EPAGE II CRITERIA IN A MOROCCAN UNIVERSITY HOSPITAL
Publication History
Publication Date:
27 March 2018 (online)
Aims:
The demand for gastrointestinal endoscopy is increasing, resulting in an important rise in overall costs and waiting lists for endoscopic procedures. Therefore, adherence to appropriate indications for these procedures is essential for the rational use of the criteria for the appropriateness for colonoscopy EPAGE (European Panel on the Appropriateness of Gastrointestinal Endoscopy) have been elaborated by a European expert panel, published in 1999 and have been updated in April 2008. Objectives:
To evaluate the appropriateness of colonoscopy indications at our hospital and assess the correlation between colonoscopy appropriateness and endoscopic and findings.
Methods:
We retrospectively analyzed 389 colonoscopies. The average age was 58 years. The referral indication was judged as appropriate, inappropriate and uncertain using a scoring system on the basis of EPAGE II criteria available at the website (http://www.epage.ch).
Results:
Appropriateness could be assessed in 95% (n = 369) of the colonoscopies. In the remaining 5%, the indication of colonoscopy was not listed in the EPAGE guidelines and consequently they were not evaluated. 70% colonoscopies were appropriate, 17% uncertain, and 13% inappropriate. An endoscopic diagnosis was made in 176 patients (48%), with a finding of significant lesions in 39% (n = 143; CCR, adenomas, inflammatory bowel disease, angiodysplasia and benign stricture). Among patients who had a significant diagnosis, 53% had an appropriate indication, 25% had an uncertain indication and 22% had an inappropriate indication. Having an appropriate indication, increasing age were significantly associated with more relevant finding at colonoscopy (p < 0.0001).
Conclusions:
Colonoscopy is not overused according to EPAGE II guidelines. The appropriateness criteria enhanced the detection of significant lesions; thereby improve the prognosis of patients with colorectal diseases.