Endoscopy 2022; 54(S 01): S176-S177
DOI: 10.1055/s-0042-1745041
Abstracts | ESGE Days 2022
ESGE Days 2022 Digital poster exhibition

NURSE-LED ENDOSCOPIC TRIAGE OF THE SUSPECTED UPPER GASTROINTESTINAL CANCER REFERRALS DURING THE COVID-19 PANDEMIC

M.G. Shiha
1   Northampton General Hospital, Department of Gastroenterology, Northampton, United Kingdom
,
L. Alleyne
1   Northampton General Hospital, Department of Gastroenterology, Northampton, United Kingdom
,
L. Wookey
1   Northampton General Hospital, Department of Gastroenterology, Northampton, United Kingdom
› Author Affiliations
 

Aims The COVID-19 pandemic had a profound negative impact on endoscopic services and capacity leading to concerns regarding delayed cancer diagnosis. We aimed to assess the efficacy and outcomes of nurse-led endoscopic telephone triage of suspected upper gastrointestinal (UGI) cancer referrals.

Methods We prospectively collected data of consecutive patients referred for urgent endoscopy through the suspected UGI cancer pathway between April 2020 and August 2021 at a large district general hospital. All patients underwent a telephone triage by the UGI nurse practitioner according to the national guidelines. Patients’ demographics, indications for referrals, endoscopy and radiology reports were reviewed and analysed.

Results A total of 809 patients were included (median age 66 (IQR 56-76) years, 56.6% female). Dysphagia (35.2%), weight loss (34.3%) and reflux (32.5%) were the most common indications for referrals. 80% (n=574) of patients were triaged to urgent endoscopy, 3.3% (n=27) were downgraded to routine endoscopy, 15.6% (n=127) to barium swallow, 1.7% (n=14) to urgent computed tomography (CT) and 8.2% (n=67) discharged without further investigations. 4.3% (n=35) of patients were diagnosed with UGI cancers of whom 84.3% (27/35) were diagnosed on urgent endoscopy, 3.1% (1/35) on barium swallow, 12.5% (4/35) on urgent CT and 8.5% (3/35) were known to have cancer. None of the patients triaged to routine endoscopy were found to have cancer.

Conclusions The nurse-led telephone triage significantly reduced the number of endoscopic procedures without affecting the diagnostic yield for UGI cancer. Adopting this model will reduce the burden on endoscopy units in the post-pandemic recovery phase.



Publication History

Article published online:
14 April 2022

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