title: Diagnostic yield of EGD in children: a retrospective single-center study of 1000 cases.
abstract: BACKGROUND
  Pediatric EGD is increasingly being used, but few studies have recently evaluated the diagnostic yield.
  
  
  OBJECTIVE
  To assess the association between presenting clinical symptoms and the likelihood of significant endoscopic and histologic abnormalities for initial diagnostic endoscopy.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Large, tertiary care children's hospital.
  
  
  METHODS
  One thousand patients, ages 1 month to 18 years, who underwent initial diagnostic EGD in 2009 and 2010.
  
  
  METHODS
  None.
  
  
  METHODS
  Endoscopic and histologic abnormalities.
  
  
  RESULTS
  The most common primary indications for endoscopy were generalized abdominal pain (28.7%), gastroesophageal reflux (11.7%), and failure to thrive (9.5%). The overall prevalence of an endoscopic abnormality was 34.7% and of a histologic abnormality, 40.4%. The highest rates of endoscopic abnormalities were found in patients with strictures on upper GI radiology (100%), foreign body (88%), and GI bleeding (57%). The highest rates of histologic abnormalities were in patients with positive celiac screening (91%), foreign body (88%), dysphagia (51%), and GI bleeding (49%), and the lowest rates of histologic abnormalities were miscellaneous indications (17%), strictures on radiology (25%), and reflux (26%). Females and patients < 1 year of age had lower rates of abnormal histologic abnormalities.
  
  
  CONCLUSIONS
  Retrospective nature of the study, limitation to a single tertiary care center, and simplification of complex patient presentations to a single indication.
  
  
  CONCLUSIONS
  Rates of endoscopic and histologic abnormalities from EGD vary based on age and indication for endoscopy, and this should be factored into the decision to proceed with initial endoscopy along with consideration of adverse event rates and effects of anesthesia.
authors.affiliation: Department of Pediatrics, Children's Hospital Colorado, Aurora, CO 80045, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Sheiko
authors.forename: James A
authors.initials: JA
authors.lastname: Feinstein
authors.forename: Kelley E
authors.initials: KE
authors.lastname: Capocelli
authors.forename: Robert E
authors.initials: RE
authors.lastname: Kramer
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D020776:Endoscopes, Gastrointestinal; D016145:Endoscopy, Digestive System / Q000379:methods* / Q000706:statistics & numerical data*; D005183:Failure to Thrive / Q000175:diagnosis; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D062606:Tertiary Care Centers