Malaysian Gastro-Intestinal Registry 1st Report 2009
OGDS
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CHAPTER 3 : OGDS
3.1 INTRODUCTION
Oesophagogastroduodenoscopy OGDS is an examination of the lining of the esophagus, stomach and upper duodenum with a small flexible endoscope, which is inserted down the
throat. It is one of the most commonly performed endoscopic procedures and provides valuable information in patients with upper gastrointestinal GI conditions. Additionally, therapeutic
OGDS forms the mainstay of treatment for upper GI bleeding.
A total of 10037 patients were referred for OGDS. The most common age distribution was 50-59 24.9 followed by 60-69 21.7.
Table 3.1 : Age distribution in OGDS
Age No.
0-10 32
0.32 10-20
241 2.40
20-30 689
6.86 30-40
800 7.97
40-50 1673
16.67 50-60
2500 24.91
60-70 2178
21.70 70-80
1527 15.21
=80 397
3.95
Total 10037
100
3.2 INDICATIONS
The appropriateness of the indications for upper gastrointestinal endoscopy OGDS is recognized as a quality indicator for Endoscopy Units. It has been demonstrated that there is a
statistically higher rate of significant pathologic findings when GI endoscopy is performed for indications listed in the American Society for Gastrointestinal Endoscopy ASGE guidelines for
GI endoscopy.
The most common indication for OGDS in this series was Dyspepsia 23.14 followed by gastrointestinal bleeding 17.31. GERD symptoms were the indication in only 447 patients
4.45. Table 3.2
9 Malaysian Gastro-Intestinal Registry
1st Report 2009
Table 3.2 : Indications for OGDS Indicators for OGDS
No. N=10037
Dyspepsia 2323
23.14 GERD symptoms
447 4.45
Dysphagia Odynophagia 230
2.29 Gastrointestinal bleeding
1737 17.31
Treatment of bleeding lesions 110
1.1 Re-evaluation of previously bleeding lesion
553 5.51
Investigation of Iron-defi ciency Anaemia 402
4.01 Suspected Portal Hypertension
343 3.42
Variceal therapy 309
3.08 Evaluation of caustic injury
7 0.07
Other therapeutic procedures 134
1.34 Other indication
184 1.83
Others 432
4.3 Not Available
3459 34.46
Total 10670
Several patients had more than one indication
The National Endoscopy Registry is an online database that has six participating large public hospitals. The current practice of open – access endoscopy allows physicians to directly
schedule procedures without prior consultation. Therefore appropriate indication is important for proper utilization of endoscopy facilities. The majority of physicians adhered to the ASGE
guidelines. Among 432 patients 4.3, which did not meet the guidelines, the common reasons for requesting the procedure were anaemia, screening and surveillance for malignancy and
chronic diarrhoea. However a significantly large proportion of patients 34.46 did not have the indications documented.
Among the documented indications for OGDS, 95.7 met the ASGE guidelines. The most common indication was Dyspepsia followed by Upper Gastrointestinal Bleeding. GERD symptoms are not
a common indication for OGDS in Malaysian patients.
3.3 DYSPEPSIA
2139 patients had OGDS done for dyspepsia during study period. 48.2 1030 were male patients. Breakdown based on ethnicity were Malays 36.5, Chinese 29.6, Indian 15.7, other
Malaysian 16.0 and 2.0 were foreigner. Ethnicity of 3 patients was not available. 58.7 of patients were 50 and above, 38.2 were between ages of 20 to 50.
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