Scandinavian journal of gastroenterology · 2026
Can the indications for gastroscopy in dyspeptic patients be tightened?
СтатьяНазвание и аннотация: Перевод в очереди
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Ollila Iida, Puustinen Lauri, Tykkä Erika, Paajanen Mikko, Punkkinen Jari, Arkkila Perttu
Аннотация
OBJECTIVE: Gastroscopy is frequently performed to investigate upper gastrointestinal (GI) symptoms. This analysis aimed to identify upper GI symptoms associated with clinically significant pathology, low-yield gastroscopies and opportunities to refine future referral guidelines.
METHODS: This retrospective study analysed symptomatic gastroscopies performed at two public hospitals between 15 January 2024 and 31 October 2024, using data from a patient registry. The association of patient age, sex and symptoms with clinically significant pathology was examined using a binary logistic regression model.
RESULTS: Altogether 643 gastroscopies were analysed. About 60.0% were performed on female patients, and 22.4% on patients aged <50 years. Significant pathology was found in 152 gastroscopies (overall 23.6%; females 19.2%; males 30.4%). The highest proportions of significant pathology were observed in patients with weight loss (34.9%), dysphagia (32.4%) or anaemia (26.8%). These symptoms were associated with higher odds of detecting significant pathology compared to dyspepsia (adjusted odds ratio [aOR] 2.83, p < 0.01, weight loss vs. dyspepsia; aOR 2.46, p < 0.01, dysphagia vs. dyspepsia; aOR 1.94, p = 0.043, anaemia vs. dyspepsia). In patients aged <50 years, significant pathology was identified in 6.7% of those with vomiting and 3.3% of those with reflux.
CONCLUSIONS: Weight loss, dysphagia and anaemia should continue to trigger investigation in all patients. Reflux and vomiting were considered low-yield symptoms in patients aged <50 years, indicating opportunities for more efficient allocation of resources. Further prospective follow-up studies are needed to assess the role of gastroscopy in patients aged 55-60 years with dyspepsia and in patients aged <50 years with reflux or vomiting.
METHODS: This retrospective study analysed symptomatic gastroscopies performed at two public hospitals between 15 January 2024 and 31 October 2024, using data from a patient registry. The association of patient age, sex and symptoms with clinically significant pathology was examined using a binary logistic regression model.
RESULTS: Altogether 643 gastroscopies were analysed. About 60.0% were performed on female patients, and 22.4% on patients aged <50 years. Significant pathology was found in 152 gastroscopies (overall 23.6%; females 19.2%; males 30.4%). The highest proportions of significant pathology were observed in patients with weight loss (34.9%), dysphagia (32.4%) or anaemia (26.8%). These symptoms were associated with higher odds of detecting significant pathology compared to dyspepsia (adjusted odds ratio [aOR] 2.83, p < 0.01, weight loss vs. dyspepsia; aOR 2.46, p < 0.01, dysphagia vs. dyspepsia; aOR 1.94, p = 0.043, anaemia vs. dyspepsia). In patients aged <50 years, significant pathology was identified in 6.7% of those with vomiting and 3.3% of those with reflux.
CONCLUSIONS: Weight loss, dysphagia and anaemia should continue to trigger investigation in all patients. Reflux and vomiting were considered low-yield symptoms in patients aged <50 years, indicating opportunities for more efficient allocation of resources. Further prospective follow-up studies are needed to assess the role of gastroscopy in patients aged 55-60 years with dyspepsia and in patients aged <50 years with reflux or vomiting.