Diagnostic and therapeutic contribution of Esophagogastroduodenoscopy without general anesthesia in patients aged 75 and older

Abstract

Abstract Background and study aims: Esophagogastroduodenoscopy (EGD) is frequently performed in older patients and allows to detect lesion in 20 to 50% of cases, it also participates to therapeutic management. However, considering that elderly population is often more fragile and this medical procedure without anesthesia may be judged uncomfortable and invasive, EGD raises questions about its benefit-risk balance in this population. We aimed to evaluate the diagnostic and therapeutic impact and tolerance of EGD without general anesthesia in older hospitalized patients. Patients and methods: We performed an observational, retrospective single-center study including patients who underwent an EGD without general anesthesia, aged 75 years and over. The primary endpoint was the description of a macroscopic lesion consistent with the indication. The secondary endpoints were the endoscopy's contributivity in the diagnostic and therapeutic approaches, and its tolerance. Results Our study included 200 patients between January 2018 and December 2019. A macroscopic diagnosis consistent with the indication was found in 88 patients (44%). When no macroscopic diagnosis was made, EGD led in 70.5% of cases to a change in treatment or the proposal of an additional procedure. Forty-six percent of EGD were well-tolerated. Conclusion In this population, EGD allows progress in the diagnostic and therapeutic approach with a good tolerance.