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• W2977417811 abstract "Introduction: Gastroesophageal reflux disease (GERD) is a serious disease with complications such as severe esophagitis, peptic strictures, barrett's esophagus, and esophageal carcinoma. The American College of Gastroenterology recommends a repeat endoscopy after 8 weeks for those patients with LA Grades C and D esophagitis. Given these recommendations, we assessed the compliance with practice guidelines by endoscopists for repeat upper endoscopy in cases of esophagitis and their endoscopic findings of repeat EGD. Methods: A retrospective chart review of patients with esophagitis using the LA grading system was performed from 2010-2014. Patients were identified using the following ICD-9 codes for both esophagitis and GERD. The data extraction included the following: Demographics (age, gender race), date of initial endoscopy, time recommended for repeat endoscopy, date of repeat endoscopy and findings at each endoscopy. We defined endoscopist as being compliant if the recommendation at initial EGD was repeated between 7-9 weeks in cases of LA Grade C or D esophagitis. Descriptive statistics was used to summarize the information on the subjects in the study. We estimate the proportion of cases that were compliant with a 95% confidence interval estimate. Results: A total of 361 charts met our inclusion criteria with mean age of 51 ± 15.3 years with 60% males and 86% Caucasians. The findings on initial endoscopy revealed: LA grade A esophagitis 110/361 (30%), grade B 92/361 (25.6%), grade C 59/361 (16.5%) and grade D 83/361 (22.8%). Grade was not documented in 17 (4.7%). We found that 139 of 361 cases (38.5%, 95% CI: 33.5-43.7) were recommended to repeat the upper endoscopy between 7-9 weeks. Compliance for repeat endoscopy was observed for 9 (17%) in LA grade A esophagitis, 39 (42%) for LA grade B, 31 (52%) for LA grade C, and 41 (49%) of LA grade D. In combining grades C and D, 50.7% compliance (95% CI: 42.1-59.1) was observed. Among 43 patients who were instructed to return in 8 weeks, 17 (40%) actually returned between 7-9 weeks while 24 (56%) returned between 6-10 weeks. The findings on repeat endoscopy showed LA Grade A healed in 14/110 cases (12.7%), LA Grade B healed in 19/93 cases (20%), LA Grade C healed in 24/60 cases (40%), LA grade D healed in 20/83 cases (24%). Interestingly, the recommendations for repeat EGD varied at 1, 4, 6, 8, or 12 weeks. Conclusion: A discrepancy in compliance of recommendations for repeat EGD in cases of severe esophagitis was apparent. A prospective study involving physician education, patient questionnaire to closely evaluate factors that impact outcome of repeat endoscopy would be of great utility and contribute to current literature." @default.
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• W2977417811 date "2015-10-01" @default.
• W2977417811 modified "2023-09-27" @default.
• W2977417811 title "Endoscopic Surveillance for Reflux Esophagitis: Is It Really Needed? A Retrospective Review and Quality Assessment" @default.
• W2977417811 doi "https://doi.org/10.14309/00000434-201510001-02261" @default.
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