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CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(03): E385-E393
DOI: 10.1055/a-2265-8757
Original article

Upper gastrointestinal endoscopy procedure volume trends, perioperative mortality, and malpractice claims: Population-based analysis

Nelli Nurminen 
1   Department of General Thoracic and Esophageal surgery, Heart and Lung Center, HUS Helsingin yliopistollisen sairaala, Helsinki, Finland (Ringgold ID: RIN3836)
,
Tommi Järvinen
1   Department of General Thoracic and Esophageal surgery, Heart and Lung Center, HUS Helsingin yliopistollisen sairaala, Helsinki, Finland (Ringgold ID: RIN3836)
,
Eric Robinson
2   Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, United States (Ringgold ID: RIN5925)
,
Nanruoyi Zhou
3   Department of Surgery, NewYork-Presbyterian Weill Cornell Medical Center, New York, United States (Ringgold ID: RIN159947)
,
Silja Salo
4   Department of Gastrointestinal Surgery, Abdominal Center, Helsinki University Central Hospital, Helsinki, Finland (Ringgold ID: RIN159841)
,
Jari Räsänen
1   Department of General Thoracic and Esophageal surgery, Heart and Lung Center, HUS Helsingin yliopistollisen sairaala, Helsinki, Finland (Ringgold ID: RIN3836)
,
Ville Kytö
5   Heart Center, TYKS Turku University Hospital, Turku, Finland (Ringgold ID: RIN60652)
6   Clinical Research Center, TYKS Turku University Hospital, Turku, Finland (Ringgold ID: RIN60652)
7   Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Ringgold ID: RIN8058)
,
Ilkka Ilonen 
1   Department of General Thoracic and Esophageal surgery, Heart and Lung Center, HUS Helsingin yliopistollisen sairaala, Helsinki, Finland (Ringgold ID: RIN3836)
› Author AffiliationsSupported by: Helsinki University Hospital Y242SK2312
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Abstract

Background and study aims Upper gastrointestinal endoscopy (EGD) is one of the most common diagnostic procedures done to examine the foregut, but it can also be used for therapeutic interventions. The main objectives of this study were to investigate trends in EGD utilization and mortality related to it in a national low-threshold healthcare system, assess perioperative safety, and identify and describe patient-reported malpractice claims from the national database.

Patients and methods We retrospectively identified patients from the Finnish Patient Care Registry who underwent diagnostic or procedural EGD between 2010 and 2018. In addition, patient-reported claims for malpractice were analyzed from the National Patient Insurance Center (PIC) database. Patient survival data were gathered collectively from the National Death Registry from Statistics Finland.

Results During the study period, 409,153 EGDs were performed in Finland for 298,082 patients, with an annual rate of 9.30 procedures per 1,000 inhabitants, with an annual increase of 2.6%. Thirty-day all-cause mortality was 1.70% and 90-day mortality was 3.84%. For every 1,000 patients treated, 0.23 malpractice claims were filed.

Conclusions The annual rate of EGD increased by 2.6% during the study, while the rate of interventional procedures remained constant. Also, while the 30-day mortality rate declined over the study period, it is an unsuitable quality metric for EGDs in comprehensive centers because a patient’s underlying disease plays a larger role than the procedure in perioperative mortality. Finally, there were few malpractice claims, with self-evident causes prevailing.



Publication History

Received: 09 November 2023

Accepted after revision: 26 January 2024

Article published online:
18 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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