JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v5i3.2445 jpsim.v5i3.2445 Original Research Upper Gastrointestinal Endoscopy A Clinical Audit of Indications and Diagnosis. A 5-Year Data Analysis of Tertiary Care Centre Waheed Ayesha Sial Talha Ghafoor Farooq Mehrin mehrinfarok@gmail.com * Zafar Shamail Ghurki Trust Teaching Hospital / Lahore Medical & Dental College Lahore *Correspondence: Mehrin Farooq (mehrinfarok@gmail.com) 30 08 2024 2024 5 3 587 590 16 02 2024 07 08 2024 Copyright © 2024 The Author(s) 2024 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective

The primary objective of this clinical audit is to evaluate the indications for upper GI endoscopy, assess the diagnostic yield, and identify the prevalence of diseases diagnosed during these procedures in a tertiary care centre.

 Methodology

This study of 864 patients took place at Department of Medicine/Gastroenterology, Ghurki Trust Teaching Hospital Lahore. A collaborative team, including experienced Gastroenterologist, Physicians, nurses, and data analysts, undertook a comprehensive review of upper GI endoscopy records. Detailed criteria for indications, diagnostic efficacy, and specific disease diagnoses were established, as per established clinical guidelines and prior research. Data was analyzed using SPSS Statistics version 24.

 Results

Out of 864 patients, 440 (50.9%) were females and 424 (49.0%) males making it approximately 1:1. Epigastric pain was the primary indication for UGIE (n=263) (30.4%) followed by Retrosternal burning (n=123) (14.2%). The commonest age group for endoscopy was 31- 40years (n=197) (22.8%). GERD, Gastritis, Duodenitis were the commonest findings on UGIE. Only 34 (3.93%) patients had no positive finding. Corrosive intake history had the lowest indication rate (n=18) (2.08%) present only in females.

 Conclusion

This clinical audit contributes to a more informed and evidence-based approach to upper GI endoscopy. Epigastric pain was the most common indication and GERD was the predominant finding. By assessing indications, diagnostic efficacy, and diseases diagnosed, we aim to optimize the utilization of this procedure, enhance diagnostic precision, and improve patient outcomes for those with upper GI disorders.

 Keywords Endoscopy Gastritis GERD Pain Epigastrium References Zafar S, Haque IU, Tayyab GU, Rehman AU, Rehman AU, Chaudhry NU. Correlation of gastroesophageal reflux disease symptoms with body mass index. Saudi J Gastroenterol. 2008;14(2):53-7. American Society for Gastrointestinal Endoscopy Guidelines: Complications of upper GI endoscopy. Gastrointest Endosc. 2002;55(7): 784-93 Van Den Bogaerde J, Sorrentino D. Bringing Top‐End Endoscopy to Regional Australia: Hurdles and Benefits. Diagnost Therapeut Endosc. 2012;2012(1):347202. Kwan V. Advances in gastrointestinal endoscopy. Intern Med J. 2012;42(2):116-26. Khurram, M., Khaar, H.B., Hasan, Z. et al. A 12 years audit of upper gastrointestinal endoscopic procedures. J Coll Phy Surg Pak. 2003;13(6), 321-4. Chowdhury J, Islam MS, Miah AR, Saha A, Pal P, Siddique AA, et al. Study of the Prevalence of Dyspepsia in the Adult Population in a Rural Community of Bangladesh. Mymensingh Med J. 2019;28(1):163–174. Lacy BE, Weiser KT, Kennedy AT, Crowell MD, Talley NJ. Functional dyspepsia:The economic impact to patients. Aliment Pharmacol Ther. 2013;38(2):170-7. Ntola VC, Pillay TG, Ramklass S. An audit of upper gastrointestinal endoscopy performed on patients at Prince Mshiyeni Memorial Hospital in Durban, KwaZulu-Natal . S Afr J Surg 2019;57 (3):55-8. Naji SA, Brunt PW, Hagen S, Mowat NA, Russell IT, Sinclair TS, Tang TM. Improving the selection of patients for upper gastrointestinal endoscopy. Gut. 1993;34(2):187-91. Chaudhry NU, Malik MA, Tayyab GN, Jawaid Q. Analysis of 25000 upper GI endoscopies of patients presenting to endoscopy unit of Mayo Hospital Lahore. Pak J of gastroenterology 1991;5(1):14. Shah NH, Shah MS, Khan I, Hameed K. Dyspepsia in Afghan refugees – do prompt endoscopy. J Ayub Med Coll Abottabad 1999;11(2):51. Katelaris PH, Tippett GH, Norbu P, Lowe DG, Brennan R, Farthing MJ. Dyspepsia, Helicobacter pylori, and peptic ulcer in a randomly selected population in India. Gut. 1992 Nov;33(11):1462–1466. Picardo NG, Ajayi NA. Indications for an endoscopic findings in patients with symptoms of upper gastrointestinal disease in a tertiary hospital in South-Eastern Nigeria. Afr J Med Health Sci. 2015;14(2):96-100 Usman A, Jamal Q, Siddiqui AR, Pervez S, Pervez J, Durrani A. Risk of hypoxia during flexible upper GI endoscopy in unsedated patients of a tertiary care public sector hospital in Karachi Pakistan. Pak J Med Sci. 2010;26(4):909-13. Kamran M, Fawwad A, Haider SI, Hussain T, Ahmed J. Upper gastrointestinal endoscopy; A study from a rural population of Sindh, Pakistan. Pak J Med Sci. 2021 Jan-Feb;37(1):9-14. Jeje E, Olajide T, Akande B. Upper Gastrointestinal Endoscopy - Our Findings Our Experience in Lagoon Hospital Lagos, Nigeria. Maced J Med Sci. 2013;6(2):168-73.