This article is more than 5 years old. Information may no longer be current.
Significant adverse outcomes rare in ambulatory pediatric endoscopy
Click Here to Manage Email Alerts
Ambulatory pediatric endoscopy appeared safe despite a somewhat increased risk for complications in some populations, according to an analysis of a large, multicenter database published in the Journal of Gastroenterology and Hepatology.
Thomas M. Attard, MD, of the department of gastroenterology at Children’s Mercy Hospital in Kansas City and lead study author, told Healio Gastroenterology and Liver Disease that the large dataset from the Pediatric Hospital Information System helped investigators look deeper into patient outcomes in an area where research has previously been limited.
“The volume of studies in the adult literature, the amount of detail they can get, it’s far better than in pediatrics,” he said. “To a large extent it’s because we are so lucky. Pediatric patients are more forgiving. There are less comorbidities.”
Attard and colleagues analyzed data from 217,817 patients aged 1 year to 21 years who underwent diagnostic endoscopy between October 2005 and September 2015 at 49 tertiary children’s hospitals in the United States. They looked for any post-procedure events that led to an unplanned hospital admission or an emergency department visit within 5 days at the same facility.
Researchers found that 101 patients were admitted directly (0.05%) and 1,314 had an emergency department visit within 5 days (0.6%). They also found that none of the procedures resulted in the death of a patient.
Despite the overall low risk for adverse outcomes, Attard and colleagues identified differences in risk among a few demographic groups. They found that female patients were more likely to experience adverse outcomes (P < .001) as were those from an urban setting (P = .0004). White, non-Hispanic patients were less likely to return for an emergency department visit after their procedure (P < .0001).
Researchers could not determine a reason for the higher risk among female patients, but Attard said an increased risk among Hispanic patients could be due to more of those patients living in urban settings and therefore, they are more likely to return to the same tertiary hospital where they underwent their procedure.
The odds of experiencing a post-procedure complication was also associated with the number of complex chronic conditions a patient had, such as neuromuscular, renal or gastrointestinal complications. Compared with no chronic conditions, the odds increased progressively from one to two chronic conditions (OR = 1.27; 95% CI, 1.09–1.47) and with three or more conditions (OR = 1.57; 95% CI, 1.12–2.2).
Attard said these findings give physicians an opportunity to consider each patient’s individual case before their procedure and determine how they should observe them after it is completed.
“The study opens other possibilities for a more targeted approach to assessing patients and preparing patients,” he said. – by Alex Young
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts