Endoscopy 2020; 52(S 01): S197-S198
DOI: 10.1055/s-0040-1704618
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 15:30 – 16:00 Do we need BIG DATA for quality assurance? ePoster Podium 4
© Georg Thieme Verlag KG Stuttgart · New York

RECOGNIZING POST-ENDOSCOPY COMPLICATIONS IN IN-PATIENTS: A DATABASE FILTER REDUCES QUALITY ASSURANCE WORKLOAD

P Karatzas
1   Department of Interdisciplinary Endoscopy, Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
,
T Rösch
1   Department of Interdisciplinary Endoscopy, Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
,
I Papanikolaou
2   Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
,
J de Heer
1   Department of Interdisciplinary Endoscopy, Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
,
G Schachschal
1   Department of Interdisciplinary Endoscopy, Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
,
S Groth
1   Department of Interdisciplinary Endoscopy, Medicine I, University Hospital Hamburg-Eppendorf, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Documentation of complications of GI endoscopy within the commonly used endoscopy documentation systems are mostly limited to acute complications during endoscopy included in the post-procedural endoscopy report. Later complications which are often even more relevant require individual patient follow-up creating substantial workload if taken seriously. We tested a documentation system based filter to reduce this workload by maintaining a high sensitivity to recognize post-endoscopy complications in an in-patient hospital system for interventional endoscopy

Methods Of all in-patient endoscopic resections during 1 year and all ERCP procedures during 4 months in one tertiary referral center, post-procedural complications during hospital stay were individually analyzed retrospectively by a careful analysis of endoscopy and hospital databases (gold standard). In comparison, IT-based filters were assessed searching for specific tests and data within 2 days after endoscopy and/or until discharge: For endoresection all cases were selected who received a second endoscopy, surgery, or an abdominal CT as well as a documented hemoglobin drop ≥2 g/dl. For ERCP cases, any case with lipase determination (not routine) and post-ERCP CT scan was selected. Main outcomes were the sensitivity of these filters (using single or combined parameters) to recognize post-endoscopy complications and the percentage of workload reduction achieved.

Results 322 in-patients who underwent endoscopic resections and 302 ERCP cases (all in-patients) were included. Post-endoscopy complications occurred in 7.14% (endoresection) and 3.7% (ERCP). The above mentioned filters identified 100% of all endoresection and post-ERCP complications compared to detailed case file analysis, at the same time reducing the QM workload to 14% and 31%, respectively.

Conclusions Post-procedural monitoring of endoscopic procedures performed on in-patient procedures has a high sensitivity (100%) and reduces case-per-case screening workload for complications by 70-85%. Out-patient interventions however require a recall system for complete monitoring of post-endoscopy complications after discharge.