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Córdova H, Sánchez-Montes C, Delgado-Guillena PG, Morales VJ, Sendino O, González-Suárez B, Cárdenas A, Pellisé M, Araujo IK, Ginés À, Llach J, Fernández-Esparrach G. Quality indicators for esophagogastroduodenoscopy: A comparative study of outcomes after an improvement programme in a tertiary hospital. GASTROENTEROLOGIA Y HEPATOLOGIA 2017. [PMID: 28648767 DOI: 10.1016/j.gastrohep.2017.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION There is an opportunity for improvement in the recording and measuring of quality indicators. However, no previous experiences exist in our field in terms of their compliance in esophagogastroduodenoscopy (EGD). OBJECTIVE To analyse compliance with EGD quality criteria and evaluate improvement after conducting a training programme. PATIENTS AND METHODS Comparative study of 2 cohorts: one retrospective (control group) and one prospective (intervention group), before and after a training programme consisting of an information session and the report writing improvement programme. The quality indicators proposed by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology were used. RESULTS A total of 1,200 EGDs were included in a sequential manner (600 in each group). Following the training programme, a significant improvement was observed in the following indicators: documented indication (93 vs. 99.8%; P<0.01), documented full examinations (94.7 vs. 97.3%; P<0.01), correct performance (63.7 vs. 87.9%; P<0.01), appropriate biopsies according to protocols (57.9 vs. 83.8%; P<0.01), photo-documentation of described lesions (84.1 vs. 94.9%; P<0.01), photo-documentation per segment (52.9 vs. 70.5%; P<0.01) and correct overall assessment (56,9 vs. 90.5%; P<0.01). Biopsies for coeliac disease, documented indication, full examination and correct performance, if it went ahead, exceeded the recommended standard. CONCLUSION A very simple training programme improves EGD quality indicators, with the majority reaching the standards recommended by the American Society for Gastrointestinal Endoscopy and the American College of Gastroenterology.
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Affiliation(s)
- Henry Córdova
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Cristina Sánchez-Montes
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Pedro G Delgado-Guillena
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España; Servicio de Gastroenterología, Hospital General de Granollers, Granollers, Barcelona, España
| | - Victor J Morales
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España; Servicio de Gastroenterología, Hospital General de Granollers, Granollers, Barcelona, España
| | - Oriol Sendino
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Begoña González-Suárez
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Andrés Cárdenas
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Maria Pellisé
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Isis K Araujo
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Àngels Ginés
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Josep Llach
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España
| | - Gloria Fernández-Esparrach
- Unidad de Endoscopia, Servicio de Gastroenterología, Institut Clínic de Malalties Digestives i Metabòliques (ICMDiM), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Hospital Clínic, Universitat de Barcelona, Barcelona, España.
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Gisbert JP, Calvet X, Feu F, Bory F, Cosme A, Almela P, Santolaria S, Aznárez R, Castro M, Fernández N, García-Grávalos R, Cañete N, Benages A, Montoro M, Borda F, Pérez-Aisa A, Piqué JM. Eradication of Helicobacter pylori for the prevention of peptic ulcer rebleeding. Helicobacter 2007; 12:279-86. [PMID: 17669099 DOI: 10.1111/j.1523-5378.2007.00490.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM To evaluate the effect of Helicobacter pylori eradication on ulcer bleeding recurrence in a prospective, long-term study including more than 400 patients. METHODS Patients with peptic ulcer bleeding were prospectively included. H. pylori infection was confirmed by rapid urease test, histology or (13)C-urea breath test. Several eradication regimens were used. Ranitidine 150 mg was administered daily until eradication was confirmed by breath test 8 weeks after completing eradication therapy. Patients with therapy failure received a second or third course of therapy. Patients with eradication success did not receive maintenance anti-ulcer therapy, and were controlled yearly with a repeated breath test. RESULTS Four hundred and twenty-two patients were followed up for at least 12 months, with a total of 906 patient-years of follow up. Mean age was 59 years, and 35% were previous nonsteroidal anti-inflammatory drug (NSAID) users. Sixty-nine percent had duodenal, 24% gastric, and 7% pyloric ulcer. Recurrence of bleeding was demonstrated in two patients at 1 year (incidence: 0.22% per patient-year of follow up), which occurred after NSAID use in both cases. CONCLUSION Peptic ulcer rebleeding does not occur in patients with complicated ulcers after H. pylori eradication. Maintenance anti-ulcer (antisecretory) therapy is not necessary if eradication is achieved.
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Affiliation(s)
- Javier P Gisbert
- Department of Gastroenterology, Hospital de la Princesa, Madrid, Spain.
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