Prevalence of clinically significant endoscopic findings and its relation to alarm symptoms and age in patients attending clinic at st. dominic hospital, akwatia, ghana

Background: Upper Gastrointestinal (UGI) symptoms are among the commonest complaints for which patients seek medical attention, with the annual prevalence of dyspepsia approximating 25%. Due to the high prevalence of dyspepsia, a prompt endoscopy for every dyspeptic patient is not a practical approach, as this will lead to high costs and low yield of endoscopy. Age and alarm symptoms, have been shown to be predictive in some studies, but not in others. This study was to examine the prevalence of significant endoscopic findings (SEF) and utility of alarm features and age in predicting SEF.
Materials and Methods: A hospital-based cross-sectional study conducted at endoscopy unit of St. Dominic Hospital. Patients with dyspepsia with or without alarm features referred for Gastroscopy were selected and endoscopic findings recorded.
Results: A total of 487 patients had upper GI endoscopy during the study period, of those 206 (42.3%) were males. Their ages ranged from age 4 to 94 years, with a median age of 48. Only 119 (24.4%) patients had SEF. Multivariable logistic regression analysis showed that age ≥50 years, presence of any alarm feature, male sex and presence of H. pylori
infection were significantly associated with the presence of SEFs
Conclusion: Dyspeptic patients have low prevalence of SEF .The presence of any alarm
features, male sex, positive H. pylori test and age ≥ 50 years are associated with higher risk of SEF. Patients <50 years with no alarm features has a low endoscopic yield; non endoscopic approach for diagnosis and management for these patients can be considered.