Identification of factors that influence tolerance of upper gastrointestinal endoscopy.
OBJECTIVE
Unsedated gastroscopy is unpleasant for some patients. The identification of factors related to tolerance would permit the selection of patients for sedation. The aim of the present study was to identify these factors.


METHODS
Five hundred and nine patients underwent diagnostic gastroscopy after the administration of topical pharyngeal anaesthesia, without sedation. Patients were grouped as to whether they had undergone prior examinations or not. Tolerance was assessed with a visual analogue scale and a questionnaire.


RESULTS
Two hundred and seventy-three (54%) patients underwent gastroscopy for the first time, and 236 (46%) patients had prior experience. Patient tolerance was poor in 84 of 273 (31%) patients undergoing gastroscopy for the first time, and in 61 of 236 (26%) patients with prior experience. Logistic regression analysis identified the following variables related to poor tolerance: (a) in patients undergoing gastroscopy for the first time: presence of gag reflex (odds ratio (OR) = 3.42, 95% confidence interval (CI) 1.90-6.17), apprehension (OR = 2.57, CI 1.33-4.95), young age (OR = 0.95, CI 0.93-0.98) and high level of anxiety (OR = 1.91, CI 0.96-3.89); (b) in patients with prior experience: apprehension (OR = 4.21, CI 1.93-9.20), poor tolerance of prior examinations (OR = 4.92, CI 1.93-12.5) and female (OR = 2.23, CI 1.09-4.57).


CONCLUSIONS
The above-mentioned factors are predictive of poor tolerance, and may enable the identification of those patients who might benefit more from sedation for gastroscopy.
Campo
R
R
Digestive Endoscopy (S.D.I.), Corporació Sanitària Parc Taulí, Sabadell, Spain. rcampo@siberia.chpt.es
Brullet
E
E
Montserrat
A
A
Calvet
X
X
Moix
J
J
Rué
M
M
Roqué
M
M
Donoso
L
L
Bordas
J M
JM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D016001:Confidence Intervals; D016292:Procedural Sedation; D005239:Fear / Q000523:psychology; D005260:Female; D005544:Forecasting; D005683:Gagging / Q000502:physiology; D005773:Gastroscopy / Q000009:adverse effects / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D018579:Patient Selection; D010614:Pharynx / Q000187:drug effects; D012737:Sex Factors; D011795:Surveys and Questionnaires
D000779:Anesthetics, Local