Prognostic impact of deprivation on esophagogastroduodenoscopy outcome

Catherine Eley; Neil D Hawkes; Emma Barlow; Richard John Egan; Wyn Lewis

doi:10.1055/a-2297-9905

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(07): E818-E829
DOI: 10.1055/a-2297-9905

Original article

Prognostic impact of deprivation on esophagogastroduodenoscopy outcome

Catherine Eley

¹School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, CF15 7QQ, United Kingdom of Great Britain and Northern Ireland

²General Surgery, University Hospital of Wales, Cardiff, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN97609)

,

Neil D Hawkes

³Department of Gastroenterology, Cwm Taf University Health Board, Abercynon, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN8911)

,

Emma Barlow

⁴Department of Surgery, Morriston Hospital, Swansea, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN97701)

,

Richard John Egan

⁴Department of Surgery, Morriston Hospital, Swansea, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN97701)

⁵School of Surgery, Swansea University, Swansea, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN7759)

,

Wyn Lewis

²General Surgery, University Hospital of Wales, Cardiff, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN97609)

› Institutsangaben

Abstract

Background and study aims Socioeconomic deprivation has long been associated with many gastrointestinal diseases, yet its influence on esophagogastroduodenoscopy (EGD) diagnosis has not been evaluated. The aim of this study was to investigate the influence of deprivation on outcomes of EGD irrespective of referral reason.

Patients and methods Two thousand consecutive patients presenting to four Health Boards in Wales beginning in June 2019 were studied retrospectively with deprivation scores calculated using the Wales Indices of Multiple Deprivation (WIMD). Patients were subclassified into quintiles for analysis (Q1 most, Q5 least deprived).

Results Inhabitants of the most deprived areas were more likely to be diagnosed with peptic ulcer (Q1 7.9%, Q5 4.7%; odds ratio [OR] 0.498, P=0.018), severe esophagitis (LA4, Q1 2.7% v Q5 0%, OR 0.089, P 0.002), Helicobacter pylori infection (Q1 5.4%, Q5 1.7%; OR 0.284, P=0.002), but less likely to be diagnosed with Barrett’s esophagus (Q1 6.3% v Q5 12.3%, OR 2.146, P=0.004) than those from the least deprived areas. New cancer diagnoses numbered 53 and were proportionately higher after presentation for urgent suspected cancer (USC, n=35, 4.6%) than for routine referrals (n=3, 0.6%, P< 0.001). Deprivation was associated with more advanced stage cancer (stage III Q1 16.7% v Q5 5.6%, OR 0.997, P=0.006: stage IV Q1 16.7% v Q2 38.9% v Q5 22.2%, OR 0.998, P=0.049).

Conclusions Deprivation was associated with two-fold more peptic ulcer disease, three-fold more H. pylori infection, and 12-fold more severe esophagitis, and more advanced cancer stage.

Keywords

Endoscopy Upper GI Tract - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE) - GI Pathology - Epidemiology

Volltext

Referenzen

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