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Evaluation of endoscopy requests in the resumption of activity during the SARS-CoV-2 pandemic: denial of nonindicated requests and prioritization of accepted requests.
- Source :
-
Revista espanola de enfermedades digestivas [Rev Esp Enferm Dig] 2020 Oct; Vol. 112 (10), pp. 748-755. - Publication Year :
- 2020
-
Abstract
- Introduction: the global SARS-CoV-2 pandemic forced the closure of endoscopy units. Before resuming endoscopic activity, we designed a protocol to evaluate gastroscopies and colonoscopies cancelled during the pandemic, denying inappropriate requests and prioritizing appropriate ones.<br />Methods: two types of inappropriate request were established: a) COVID-19 context, people aged ≤ 50 years without alarm symptoms and a low probability of relevant endoscopic findings; and b) inappropriate context, requests not in line with clinical guidelines or protocols. Denials were filed in the medical record. Appropriate requests were classified into priority, conventional and follow-up. Requests denied by specialty were compared and the findings of priority requests were evaluated.<br />Results: between March 16th and June 30th 2020, 1,658 requests (44 % gastroscopies and 56 % colonoscopies) were evaluated, of which 1,164 (70 %) were considered as appropriate (priority 8.5 %, conventional 48 %, follow-up 43 % and non-evaluable 0.5 %) and 494 (30 %) as inappropriate (20 % COVID-19 context, 80 % inappropriate context). The reasons for denial of gastroscopy were follow-up of lesions (33 %), insufficiently studied symptoms (20 %) and relapsing symptoms after a previous gastroscopy (18 %). The reasons for denial of colonoscopies were post-polypectomy surveillance (25 %), colorectal cancer after surgery (21 %) and a family history of cancer (13 %). There were significant differences in denied requests according to specialty: General Surgery (52 %), Hematology (37 %) and Primary Care (29 %); 31 % of priority cases showed relevant findings.<br />Conclusions: according to our study, 24 % of endoscopies were discordant with scientific recommendations. Therefore, their denial and the prioritization of appropriate ones optimize the use of resources.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
COVID-19
Clinical Protocols
Colonoscopy trends
Female
Gastroscopy trends
Health Care Rationing trends
Health Services Accessibility trends
Hospitals, Public standards
Hospitals, Public trends
Humans
Infection Control standards
Infection Control trends
Male
Middle Aged
Practice Guidelines as Topic
SARS-CoV-2
Spain
Tertiary Care Centers standards
Tertiary Care Centers trends
Young Adult
Betacoronavirus
Colonoscopy standards
Coronavirus Infections prevention & control
Gastroscopy standards
Health Care Rationing standards
Health Services Accessibility standards
Infection Control methods
Pandemics prevention & control
Pneumonia, Viral prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1130-0108
- Volume :
- 112
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Revista espanola de enfermedades digestivas
- Publication Type :
- Academic Journal
- Accession number :
- 32954775
- Full Text :
- https://doi.org/10.17235/reed.2020.7375/2020