Appropriateness Of Colonoscopy Indications Using Criteria Established By A European Panel Of Experts: Experience In An Open Access Endoscopy Center In Tunisia

Aims Appropriate use of colonoscopy is a key component of quality management in gastrointestinal endoscopy.

The aim of this study was to evaluate the appropriateness of colonoscopy indications in our clinical practice according to EPAGE II criteria.

Methods A retrospective study including all colonoscopies from January 2017 to December 2018 was conducted. Patients with incomplete visualization of the entire colon or colonoscopic findings as indication were excluded. The appropriateness of colonoscopy was assessed based on EPAGE II criteria using a scoring system available on the website (http://www.epage.ch).

Results A total of 1307 patients were included, with a mean age of 54 years [18-94 years] and a sex ratio of 1.2. Most patients were referred by gastroenterologist (78.5 %) in an outpatient setting (75.4 %). The most common indications for colonoscopy were abdominal pain (21 %) and uncomplicated diarrhea (11.6 %). Appropriateness could be assessed in 97.6 % of the colonoscopies. In the remaining 2.4 % (n = 31), the indication of colonoscopy was not listed in the EPAGE guidelines and they were not evaluated. The indication was considered appropriate in 76.5 %; it was uncertain in 10.3 % and inappropriate in 10.9 %. Surveillance after colonic polypectomy and evaluation of known inflammatory bowel disease were the indications exhibiting higher inadequacy. Significant endoscopic lesions were found in 587 colonoscopies, dominated by polyps in 34.2 %. A clinically relevant diagnosis was established in 60.4 % (n = 335). Among patients with significant diagnosis, 89.2 % had an appropriate indication, 7 % has an uncertain indication and 10.9 % had an inappropriate indication. Having an appropriate indication, increasing age (> 50 years) were significantly associated with more relevant finding at colonoscopy (p<0.0001).

Conclusions According to EPAGE II criteria, our indications were appropriate in more than 75 % of colonoscopies. Using EPAGE II criteria in clinical practice can enable a better selection of colonoscopy referrals and increase the rate of significant lesions detection.

Citation: Hammami A, Hassine A, Zinelabidine F et al. OP200 APPROPRIATENESS OF COLONOSCOPY INDICATIONS USING CRITERIA ESTABLISHED BY A EUROPEAN PANEL OF EXPERTS: EXPERIENCE IN AN OPEN ACCESS ENDOSCOPY CENTER IN TUNISIA. Endoscopy 2021; 53: S82.

Publication History

Article published online:
19 March 2021