World journal of gastrointestinal endoscopy · 2025
Impact of referral delays on dysphagia outcomes in a Saudi tertiary center.
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AlQahtani Khaled M, AlNasser Abdulkreem A, AlQahtani Ali M, AlTurki Abdulaziz A, Aljaili Aseel K, Alamri Abdulkhaleq H, Owayed Ali S, Asiri Yasser W, Bakkari Shakir A, Jaddoh Ameen M, Aldarsouny Thamer A, Semaan Toufic G, Elbayoumy Mohamed S, Alruzug Ibrahim M, Alenezi Alhumidi A, Bin-Ofaysan Mohammed S, Alsager Mohammed O, Alshahrani Hatim S, Alhaddad Sultan M, Almuhayzi Hisham N, Almousa Rana A, Shehada Awad J, AlMasri Adnan A, Aldaher Manhal K, Maaly Mostafa E, Hafez Ihab M, Alzubide Saeed R
Аннотация
BACKGROUND: Dysphagia requires prompt evaluation but data regarding referral-to-assessment intervals and its association with outcomes in tertiary care are scarce, especially in Saudi Arabia.
AIM: To investigate the assessment and outcome of consecutive dysphagia referrals to a tertiary gastroenterology practice.
METHODS: This retrospective single-center study analyzed 207 consecutive dysphagia referrals to King Saud Medical City (2022-2023). Data collection included referral timelines, diagnostic investigations, etiologies and outcomes. Statistical Package for the Social Sciences version 28.0, employing χ 2 tests and analysis of variance, with P < 0.05 considered statistically significant.
RESULTS: Total 168 patients included in this study (mean age 45.7 ± 17.7 years, 50% male), referral delays > 2 weeks occurred in 44% for clinical assessment and 50% for endoscopy. Gastroesophageal reflux disease was most common (45.2%), followed by eosinophilic esophagitis (14.8%) and malignancy (6.5%). Patients receiving endoscopy within 2 weeks showed an 84.6% improvement, compared to 76.0% with delayed referral (P = 0.012). All malignant cases were referred within 2 weeks, compared to 52.7% of non-malignant cases (P = 0.013). However, 67% of the malignant cases worsened, and 33% died.
CONCLUSION: Early endoscopy within 2 weeks provides significant benefit. Optimised management of dysphagia should consist of more direct referral pathways.
AIM: To investigate the assessment and outcome of consecutive dysphagia referrals to a tertiary gastroenterology practice.
METHODS: This retrospective single-center study analyzed 207 consecutive dysphagia referrals to King Saud Medical City (2022-2023). Data collection included referral timelines, diagnostic investigations, etiologies and outcomes. Statistical Package for the Social Sciences version 28.0, employing χ 2 tests and analysis of variance, with P < 0.05 considered statistically significant.
RESULTS: Total 168 patients included in this study (mean age 45.7 ± 17.7 years, 50% male), referral delays > 2 weeks occurred in 44% for clinical assessment and 50% for endoscopy. Gastroesophageal reflux disease was most common (45.2%), followed by eosinophilic esophagitis (14.8%) and malignancy (6.5%). Patients receiving endoscopy within 2 weeks showed an 84.6% improvement, compared to 76.0% with delayed referral (P = 0.012). All malignant cases were referred within 2 weeks, compared to 52.7% of non-malignant cases (P = 0.013). However, 67% of the malignant cases worsened, and 33% died.
CONCLUSION: Early endoscopy within 2 weeks provides significant benefit. Optimised management of dysphagia should consist of more direct referral pathways.