APPROPRIATENESS OF INDICATION FOR COLONOSCOPY IN A TUNISIAN ENDOSCOPY UNIT

Aims:

Colonoscopy is an increasing and reliable procedure. Given the high costs and potential risks, appropriate indication may be facilitated by referring to qualifying criteria such as those devised by the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE II).

Aim: to evaluate the applicability and efficacy of these criteria in clinical practice.

Methods:

A retrospective study including all colonoscopies performed from january 2016 to july 2017. The appropriateness of coloscopy was assessed based on EPAGE II criteria before the procedure, which classify the pertinence to: appropriate, uncertain, inappropriate. Colonoscopies whose indications were not included in the EPAGE II criteria were excluded.

Results:

A total of 1360 patients were included, with a mean age of 58.6 years (17 – 92 years). The sex ratio was 1.3. The most common indications for colonoscopy were: constipation (19.1%) and abdominal pain (18.2%). The indication was considered appropriate in 62.3% (n = 821); it was uncertain in 20% of cases and inappropriate in 17.7%. Endoscopic lesions were found in 556 (42.2%) colonoscopies, dominated by polyps in 26% and diverticulosis in 8.6% of cases. Among patients with clinically significant lesions detected by colonoscopy, 60.9% had an appropriate indication (P = 0.02). Endoscopic lesions with appropriate indication were significantly found in case of anemia (p = 0.04) and rectal bleeding (p = 0.03).

Conclusions:

According to the EPAGE II criteria, our indications were appropriate in more than 60% of colonoscopies. The significant correlation between these criteria and the presence of endoscopic lesions encourage their use to rationalize colonoscopy demand.