Use of alarm features in predicting significant endoscopic findings in Nigerian patients with dyspepsia.
Date
2019
Authors
Odeghe, E.A
Adeniyi, O.F
Oyeleke, G.K
Keshinro, S
Journal Title
Journal ISSN
Volume Title
Publisher
Panafrican Medical Journal
Abstract
Introduction: dyspepsia is prevalent in the community. Guidelines recommend early endoscopy in dyspeptic patients who are older than 55 years,
or have alarm features. There is a lack of data on endoscopy in patients with alarm features in Nigeria. Methods: a retrospective study of the
endoscopic findings in adults with dyspepsia and alarm features, between August 1st 2017 and July 31st 2018 in Lagos, Nigeria. Data were analysed
using Statistical Package for Social Sciences, version 23.0. The sensitivity, specificity, positive predictive value, and negative predictive value of the
alarm features were calculated. Results: one hundred and fifty-nine gastroscopies were performed during this period, mean age was 47.8 (±14.4)
years, 49.1% were male. Dyspepsia was the commonest indication for endoscopy (80.5%), 60.2% of the dyspeptics had at least one alarm feature.
The most frequent dyspeptic symptom was epigastric pain/burning sensation (75%), while the commonest alarm features were recent onset
dyspepsia in a patient over 45 years (79%) and unexplained weight loss (28.6%). Endoscopy was normal in 26%. The most frequent significant
endoscopic findings were gastritis (49%) and gastric ulcer (17%) and they were not associated with alarm features. Upper gastrointestinal bleeding,
persistent vomiting and odynophagia were specific for significant endoscopic findings. The pooled sensitivity, specificity, positive predictive value,
and negative predictive value of the alarm features were 65%, 49%, 71% and 41% respectively. Conclusion: patients with dyspepsia and upper
gastrointestinal bleeding, persistent vomiting or odynophagia, should be referred for prompt upper GI endoscopy
Description
Keywords
Dyspepsia, alarm features, endoscopy, Nigeria
Citation
Odeghe EA, Adeniyi OF, Oyeleke GK, Keshinro SO. Use of alarm features in predicting significant endoscopic findings in Nigerian patients with dyspepsia. Pan Afr Med J. 2019;34:66.