DOI QR코드

DOI QR Code

Factors impacting patient cooperation during elective gastroscopy

  • Lee, Sang Pyo (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Sung, In-Kyung (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Kim, Jeong Hwan (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Lee, Sun-Young (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Park, Hyung Seok (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Shim, Chan Sup (Department of Internal Medicine, Konkuk University School of Medicine)
  • Received : 2015.12.05
  • Accepted : 2016.07.11
  • Published : 2017.09.01

Abstract

Background/Aims: Some people have difficulty tolerating upper endoscopy. The cause of and risk factors for this are not well known. The aim of this study was to investigate the factors involved in poor cooperation during screening upper endoscopy. Methods: A total of 4,422 subjects who underwent a health inspection with upper endoscopy carried out by a single experienced endoscopist were included. We retrospectively investigated subjects' self-reporting questionnaires and medical records, including endoscopic and histologic findings. The examinees' cooperation and the completeness of endoscopic examination were evaluated based on the operator's subjective judgment. Results: Examinee cooperation during the endoscopic procedure was poor in 358 out of 4,422 subjects (8.1%). Of the subjects with poor cooperation, the endoscopic examination was incomplete in 36 subjects (10.1%). Multivariate analysis revealed that young age (< 40 years), female sex, high body mass index (${\geq}25$), hiatal hernia, and procedural sedation using midazolam were independent risk factors for poor cooperation. Conclusions: Cooperation during screening upper endoscopy was poor in a considerable number of examinees. Endoscopists must keep in mind that examinee cooperation is more likely to be poor in the young, obese people, women, patients with hiatal hernias, and those who receive procedural sedation.

Keywords

References

  1. Dan YY, So JB, Yeoh KG. Endoscopic screening for gastric cancer. Clin Gastroenterol Hepatol 2006;4:709-716. https://doi.org/10.1016/j.cgh.2006.03.025
  2. Mahajan RJ, Johnson JC, Marshall JB. Predictors of patient cooperation during gastrointestinal endoscopy. J Clin Gastroenterol 1997;24:220-223. https://doi.org/10.1097/00004836-199706000-00007
  3. Evans LT, Saberi S, Kim HM, Elta GH, Schoenfeld P. Pharyngeal anesthesia during sedated EGDs: is “the spray” beneficial? A meta-analysis and systematic review. Gastrointest Endosc 2006;63:761-766. https://doi.org/10.1016/j.gie.2005.11.059
  4. Roman S, Kahrilas PJ. The diagnosis and management of hiatus hernia. BMJ 2014;349:g6154. https://doi.org/10.1136/bmj.g6154
  5. Menon S, Trudgill N. Risk factors in the aetiology of hiatus hernia: a meta-analysis. Eur J Gastroenterol Hepatol 2011;23:133-138. https://doi.org/10.1097/MEG.0b013e3283426f57
  6. Cohen LB, Delegge MH, Aisenberg J, et al. AGA Institute review of endoscopic sedation. Gastroenterology 2007;133:675-701. https://doi.org/10.1053/j.gastro.2007.06.002
  7. Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy, Lichtenstein DR, Jagannath S, et al. Sedation and anesthesia in GI endoscopy. Gastrointest Endosc 2008;68:815-826. https://doi.org/10.1016/j.gie.2008.09.029
  8. Triantafillidis JK, Merikas E, Nikolakis D, Papalois AE. Sedation in gastrointestinal endoscopy: current issues. World J Gastroenterol 2013;19:463-481. https://doi.org/10.3748/wjg.v19.i4.463
  9. American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists. Anesthesiology 2002;96:1004-1017. https://doi.org/10.1097/00000542-200204000-00031
  10. Tytgat GN. The Sydney System: endoscopic division. Endoscopic appearances in gastritis/duodenitis. J Gastroenterol Hepatol 1991;6:223-234. https://doi.org/10.1111/j.1440-1746.1991.tb01469.x
  11. Nomura S, Ida K, Terao S, et al. Endoscopic diagnosis of gastric mucosal atrophy: multicenter prospective study. Dig Endosc 2014;26:709-719. https://doi.org/10.1111/den.12286
  12. Ahn SY, Lee SY, Hong SN, et al. Endoscopic diagnosis of open-type atrophic gastritis is related to the histological diagnosis of intestinal metaplasia and Cdx2 expression. Dig Dis Sci 2011;56:1119-1126. https://doi.org/10.1007/s10620-010-1531-8
  13. Frank SH, Zyzanski SJ. Stress in the clinical setting: the Brief Encounter Psychosocial Instrument. J Fam Pract 1988;26:533-539.
  14. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561-571. https://doi.org/10.1001/archpsyc.1961.01710120031004
  15. Lee SP, Sung IK, Kim JH, Lee SY, Park HS, Shim CS. The effect of emotional stress and depression on the prevalence of digestive diseases. J Neurogastroenterol Motil 2015;21:273-282. https://doi.org/10.5056/jnm14116
  16. Song EM, Jung HK, Jung JM. The association between reflux esophagitis and psychosocial stress. Dig Dis Sci 2013;58:471-477. https://doi.org/10.1007/s10620-012-2377-z
  17. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 2009;10:447-485.
  18. Arendt-Nielsen L, Bajaj P, Drewes AM. Visceral pain: gender differences in response to experimental and clinical pain. Eur J Pain 2004;8:465-472. https://doi.org/10.1016/j.ejpain.2004.03.001
  19. Pandolfino JE, El-Serag HB, Zhang Q, Shah N, Ghosh SK, Kahrilas PJ. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 2006;130:639-649. https://doi.org/10.1053/j.gastro.2005.12.016
  20. Wilson LJ, Ma W, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol 1999;94:2840-2844. https://doi.org/10.1111/j.1572-0241.1999.01426.x

Cited by

  1. Unsedated Transnasal Endoscopy for Preoperative Examination of Bariatric Patients: a Prospective Study vol.30, pp.1, 2020, https://doi.org/10.1007/s11695-019-04120-y
  2. Impact of endoscopic sedation on gastric polyp detection: A one-center retrospective observational study vol.99, pp.41, 2017, https://doi.org/10.1097/md.0000000000022556