[Inappropriateness rate for colonoscopy indications in an open access unit].
OBJECTIVE
The suitability of indications for colonoscopy is important to optimize the available resources. The aim of this study was to assess the appropriateness of colonoscopy indications in an open access endoscopy unit using the EPAGE II criteria.


METHODS
Colonoscopies performed between October 1 and November 30, 2011 were retrospectively included. The appropriateness of the colonoscopy was established according to the EPAGE II criteria. Demographics, medical applicants, indications and relevant findings from these examinations were recorded.


RESULTS
We included 440 colonoscopies (60.8 ± 016.3 years, 54% women). The indication was appropriate in 75.4% (CI, 71-79.3%), uncertain in 13.1% (CI, 10.2-16.6%) and inappropriate in 11.4% (CI, 8.7-14.8%). In the univariate analysis, the relevant findings in the colonoscopy were associated with age, sex, colonoscopy indications and EPAGE II. In the logistic regression analysis, factors independently associated with the presence of relevant findings were age (≥ 50 years) (OR, 1.84), male sex (OR, 2.7) and two indications, inflammatory bowel disease and post-polypectomy surveillance (P < .03). The diagnostic yield of EPAGE II criteria was 37.3% for appropriate colonoscopies and 28.3% for inappropriate colonoscopies (P = .09).


CONCLUSIONS
The rate of unnecessary colonoscopy is high, especially in young patients (<50 years) and some colonoscopy indications. Age (≥ 50 years) and male sex are independently associated with the presence of relevant findings in colonoscopy. The diagnostic yield of EPAGE II criteria does not differ between appropriate and inappropriate examinations.
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Xavier
X
Andújar
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Empar
E
Sainz
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Alex
A
Galí
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Carme
C
Loras
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Montserrat
M
Aceituno
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Jorge C
JC
Espinós
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Josep M
JM
Viver
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España.
Maria
M
Esteve
Servicio de Aparato Digestivo, Hospital Universitari Mutua Terrassa, CIBERehd, Terrassa, España. Electronic address: ffbanares@mutuaterrassa.es.
Fernando
F
Fernández-Bañares
D000328:Adult; D000367:Age Factors; D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis* / Q000601:surgery; D003113:Colonoscopy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
Colonoscopia; Colonoscopy; EPAGE II; Open access unit; Unidad de acceso abierto