[Open acess to endoscopy in a tertiary referal center].
OBJECTIVE
The purpose of this study was to determine the yield of open access endoscopy in a third level Mexican hospital.


BACKGROUND
Open access endoscopy is common in United States of America and Europe (endoscopy is performed without prior specialist consultation). In Mexico this system hasn't become popular yet. The usefulness of open access endoscopy has been questioned. Some indications for upper gastrointestinal endoscopy (UGE) aren't included in the guidelines for appropriate use of endoscopy.


METHODS
All patients referred to diagnostic UGE in our hospital were admitted during a period of 30 days. The indications of UGE were analyzed by means the American Society of Gastrointestinal Endoscopy (ASGE) guidelines for the appropriate use of upper gastrointestinal endoscopy. Relevant findings were analyzed to all UGE performed in the study.


RESULTS
The mean age of the 208 patients studied was 52.5 years; 169 UGE (81.2%) were appropriated according to the ASGE guidelines. Seventy-five percent of appropriate UGE had relevant findings compared with 59% of inappropriate UGE (p < 0.05). There wasn't difference when compared the rate of relevant findings in appropriate UGE (75%) with 72% in all UEG performed. Ten patients had indications that didn't fit in the ASGE guidelines.


CONCLUSIONS
The appropriate EGDs have more relevant findings but the inappropriate EGDs have an important number of relevant findings too. The ASGE guidelines are not always suitable for all patients. This study supports the usefulness of open acces endoscopy.
Morelos
Erick Joel Reyes
EJ
Servicio de Endoscopia Gastrointestinal, Unidad Médica de Alta Especialidad Dr. Antonio Fraga Mouret, Centro Médico La Raza, Instituto Mexicano del Seguro Social, México, D.F. erick_joel@latinmail.com
Cruz
Enrique Paredes
EP
Hernández
Margarita Guerrero
MG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000473:pathology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged