Predictors of positive esophagogastroduodenoscopy outcomes in children and adolescents: a single center experience

Hernando Lyons,Ying Zhang,Rajmohan Dharmaraj,Susan Szpunar

doi:10.1186/s13104-017-2693-7

Abstract

BackgroundEsophagogastroduodenoscopy (EGD) has become a key element in the diagnosis and therapy of many gastrointestinal diseases affecting children. The aim of this study was to evaluate predictors of positive outcomes in children undergoing their first diagnostic EGD with biopsies at a single center.ResultsThis retrospective study was based on findings from existing EGD and histopathological reports. All procedures were performed between July 2006 and July 2013. Details of each patient’s clinical presentation and EGD were abstracted from medical records to determine the predictors of positive EGD outcomes. A total of 1133 records of patients between the ages of 0 and 18 years old were evaluated. Of these patients, 51.5% (n = 573) were female and 24.5% (n = 278) were younger than 4 years old. The mean age at the time of EGD was 9.6 ± 5.7 years (mean ± standard deviation). The most common indications for the procedure were abdominal pain (54.9%) and emesis (31.9%). The overall prevalence of any endoscopic abnormality was 54.5% and the overall prevalence of any histological abnormality was 59.1%. A multivariate logistic regression found that patients 12 years or older (odds ratio, OR = 1.46; 95% confidence interval, CI 1.31–1.63), African–American race (OR = 2.20; 95% CI 1.45–3.34), dysphagia (OR = 1.96; 95% CI 1.28–3.00) and positive celiac antibodies (OR = 2.25; 95% CI 1.52–3.34) were all significant independent predictors of a positive EGD outcome.ConclusionsSeveral clinical variables were found to be independent predictors of positive EGD outcomes in children and adolescents. Prospective studies using standardized definitions of clinical variables and endoscopy outcomes are needed to further understand predictors of positive EGDs.

Highlights

Esophagogastroduodenoscopy (EGD) has become a key element in the diagnosis and therapy of many gastrointestinal diseases affecting children
Pediatric gastroenterology is an American Board of Pediatrics certified subspecialty that emerged from earlier training of pediatricians in adult gastroenterology units and an increased recognition of gastrointestinal disorders that are unique to children
The overall prevalence of any endoscopic abnormality was 54.5%, with findings occurring in the esophagus in 29.2% of patients, stomach 25.2%, and duodenum 13%

Summary

Introduction

Esophagogastroduodenoscopy (EGD) has become a key element in the diagnosis and therapy of many gastrointestinal diseases affecting children. Pediatric gastroenterology is an American Board of Pediatrics certified subspecialty that emerged from earlier training of pediatricians in adult gastroenterology units and an increased recognition of gastrointestinal disorders that are unique to children. Over the past 30 years, the number of pediatric gastroenterologists has greatly increased. While there used to be only a few specialists based out of select centers around the world, pediatric gastroenterology is an ever-growing specialty with approximately one pediatric gastroenterologist per 100,000 children in the United States [1]. With the development of a subspecialty focused on the disorders of the pediatric gastrointestinal tract, new technologies were developed to aid in diagnoses such as pediatric esophagogastroduodenoscopy (EGD). Over the past 30 years, pediatric EGD has evolved from an infrequent procedure performed in the operating room with a monocular viewing of the

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