The Yield of Prioritization of Gastrointestinal Endoscopy Activities According to the European Society of Gastrointestinal Endoscopy Recommendations.

Abstract

Background and aims: Endoscopic procedures prioritization is an important tool for defining healthcare resources distribution in a daily practice and more important in times of limited resources such as the COVID 19 pandemic. We assessed the completion rate of endoscopic procedures that were canceled by the patients themself, based on the prioritization strategy recommended by the European Society of Gastrointestinal Endoscopy (ESGE) and examine what were the outcomes of the procedures' cancellation according to the endoscopic different indications.

Methods: Retrospective analysis of all the self-cancelled procedures during March 2020 at our tertiary endoscopic referral center. The completion rate was estimated until July 2021. The procedure's primary indications were classified according to the ESGE position statement ("always perform/high priority" vs. "low-priority/postpone always"); Endoscopic findings were classified as "significant", defined as advanced neoplasia/ a clinically significant intervention, or "other".

Results: We included 194 patients (mean age 60.4±15.3 years old; 44.8% females, 90.7% colonoscopies, 20.1% classified as "always perform/ high priority"). The completion rate in the "perform always/high priority" groups versus the "low-priority/postpone always" groups was 51.3% versus 70.3%, (p=0.024). In contrast, the rate of significant endoscopic findings in the "perform always/high priority" groups versus the "low-priority/postpone always" groups was 40.0% versus 7.3%, (p<0.001).

Conclusions: Patients who are prioritized according to the ESGE classification have a higher rate of significant findings but a lower likelihood of completing the procedure. This highlights the need for improving implementation of prioritization strategy based on the ESGE classification.