Clinical implications of endoscopic ultrasound: the American Endosonography Club Study
| Autor: | R. Hawes, M. Canto, Marc F. Catalano, C. Schmitt, C. J. Lightdale, M. Kimmey, M. Sivak, J. Affronti, Nicholas Nickl, L. D. Roubein, A. Chak, B. Hoffman, M. Johnson, M. S. Bhutani, P. Stevens, H. W. Boyce |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Endoscopic ultrasound medicine.medical_specialty Adolescent Gastrointestinal Diseases Cross-sectional study MEDLINE Sensitivity and Specificity Endoscopy Gastrointestinal Endosonography Diagnosis Differential Reference Values Risk Factors Health care medicine Humans Multicenter Studies as Topic Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Societies Medical Aged Aged 80 and over medicine.diagnostic_test business.industry Data Collection General surgery Gastroenterology Middle Aged digestive system diseases Endoscopy Surgery Endoscopes Gastrointestinal Cross-Sectional Studies Female Club business Complication |
| Zdroj: | Gastrointestinal Endoscopy. 44:371-377 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/s0016-5107(96)70083-4 |
| Popis: | Background: Despite increased clinical use of endoscopic ultrasound (EUS), there are little data regarding complications of EUS or its impact on patient management. Methods: A prospective multicenter study was completed to evaluate clinical outcomes of EUS. Before each EUS examination the endosonographer recorded further theoretical patient management plans as if EUS was unavailable. After the EUS, endosonographers recorded actual management plans based on EUS results. The actual management plan after EUS was compared to the theoretical management before EUS. Complications were assessed in short-term follow-up. Results: Four hundred twenty-eight subjects were enrolled. Of subjects able to be evaluated, EUS changed the treatment plan in 74%. Management changes of major importance occurred in 120 patients (31% of subjects able to be evaluated) and included decisions regarding surgery (62 patients), decisions regarding nonsurgical invasive management (36 patients), and decisions regarding further follow-up (22 patients). When there was a change in management, the change was to less costly, risky, or invasive management in 55%, to more costly/risky/invasive in 37%, and to equally costly/risky/invasive in 8%. Short-term follow-up was completed in 81% of subjects, with six complications identified (1.7%). Three complications were mild, two were moderate, one severe, and none fatal. Conclusions: (1) Changes in management plan may occur in the majority of patients based on EUS results. (2) The management changes are often of major importance with regard to health care costs and safety, and are more often in the direction of less costly, risky, and invasive management. (3) EUS is safe in experienced hands. (Gastrointest Endosc 1996;44:371-7.) |
| Databáze: | OpenAIRE |
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