523 Is Sore Throat an Under-Reported and Under-Estimated Quality Indicator of Endoscopic Procedures? Results From a Large Prospective Cohort

Abstract

INTRODUCTION: Patients can develop of sore throat after upper endoscopy procedures (UGI) (oral endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), double balloon enteroscopy (DBE) and gastroscopy (EGD)) but there is limited data on incidence and its risk factors. Aim: From a large prospective cohort of patients undergoing endoscopy 1) to evaluate for incidence of sore throat and 2) to identify independent risk factors for sore throat. METHODS: Data was collected prospectively on consecutive outpatient endoscopy procedures performed at Cedars-Sinai Medical Center from Oct 2018 - Feb 2019. Patients were given pre- and immediate post-procedure surveys evaluating for sore throat (pain scale from 1-10). Intraprocedural information was collected by a procedure nurse. Fisher's exact test and Mann-Whitney U test were utilized for univariate analysis; significant variables (P < 0.05) were entered into a multivariate logistic regression model. RESULTS: Data was collected on 715 patients. Patients undergoing lower GI procedures alone (n = 226, 31.6%) were excluded; the rate of sore throat in these patients was lower than patients undergoing UGI procedures (1.3% vs. 19.2%, P < 0.01). Patients with pre-procedure sore throat were excluded (17, 2.4%). In total, 472 patients (mean age = 61 years, females = 53%) met inclusion criteria and were included in the analysis (Table 1). 85 patients (18%) experienced post-procedure sore throat. 9.4% and 29.4% of them reported throat soreness as severe (level ≥ 8/10) or moderate (level 5-7/10) respectively. On univariate analysis, female gender (OR 1.8), oral EUS (OR 1.8), oral DBE (OR 5.3), fellow involvement (OR 2.3), throat suctioning (OR 2.1), general anesthesia (OR 3.9) and use of an oral airway (OR 4.1) and prolonged procedure (>30 minutes, OR 1.9) were risk factors for sore throat (all P < 0.05) (Table 2). On the multivariate analysis (all P < 0.05), the independent risk-factors to post-procedure sore throat were oral DBE (OR 5.2), oral airway (OR 4.8), general anesthesia (OR 2.7), fellow involvement (OR 2.5), oral EUS (OR 2.4), and female gender (OR 2.0) (Table 3). CONCLUSION: Throat soreness after endoscopic procedures is common (18%), with 39% rated by patients as either moderate or severe. Two endoscopy types, 2 anesthesia maneuvers, female gender and fellow involvement were all risk factors. Future studies are warranted to further characterize this under-reported and under-estimated quality indicator.