Prospective analysis of negative outcomes 30 days after outpatient upper endoscopy

Negative outcomes (complications) as perceived by the patient at thirty day follow-up are greater in number than negative outcomes detected at our monthly Quality Assurance meetings. Our objectives were to establish which negative outcomes patients reported after upper endoscopy, and to determine if any risk factors could predict these negative outcomes. Methods: Trained interviewers performed standardized telephone interviews on outpatients undergoing upper endoscopy over a 6 month period. Patients were queried regarding potential events related to their upper endoscopy in the thirty days subsequent, including symptoms, physician/ER visits and hospitalizations. The indications, findings and therapies performed during these procedures were reviewed from endoscopic reports. Results: 237 patients were successfully contacted 30 days after their outpatient upper endoscopy. The average age of these patients was 54.6, and 54.4% were female. 19% of patients undergoing upper endoscopy (45) had negative outcomes 30 days after their procedure, whereas only 3,4% were reviewed at our monthly QA meeting. The most common negative outcomes after 30 days were sore throat (23 patients) and abdominal pain (9 patients). The most common reason for being evaluated at our monthly QA meeting was hypoxemia (3 patients). 8 (3.4%) patients required an ER or physician visit, and 3 patients (1.3%) required hospitalization. The most common reason for an ER/physician visit was sore throat (3). Of the patients requiring hospitalization two were admitted for r/o perforation after dilation, and one for presyncope. Females were more likely to report negative outcomes (24% vs. 13%), and to require ER/physician visits (7/8). Dyspepsia as an indication resulted in the most negative outcomes at 30 days (24.6%), and dysphagia as an indication resulted in the most ER/physician visits (4/8) and hospitalizations (2/3). Patients with a normal upper endoscopy had the highest rate of negative outcomes at 30 days (26.8%). Conclusions: 19% of patients complained of a negative outcome 30 days after outpatient upper endoscopy. 51% of these negative outcomes were due to sore throat. Females were more likely to report, negative outcomes, and to require ER/physician visits than males. Upper endocopies performed for dyspepsia resulted in the greatest number of negative outcomes at 30 days, but those performed for dysphagia resulted in the greatest number of ER/physician visits and hospitalizations.