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Article Dans Une Revue Alimentary Pharmacology and Therapeutics Année : 2010

Impact of the Rome II Pediatric Criteria on the Appropriateness of the Upper and Lower Gastrointestinal Endoscopy in Children

Erasmo Miele
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Eleonora Giannetti
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Massimo Martinelli
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Antonella Tramontano
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Luigi Greco
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Résumé

Background: The demand for pediatric GI endoscopy has increased, resulting in a significant rise in overall costs. Aim: to assess the clinical impact of the Rome II criteria for FGIDs in selecting pediatric patients who underwent GI endoscopy. Methods: Indications and findings of GI endoscopic procedures performed before and after the publication of the Rome II criteria were retrospectively evaluated. Results: Upper GI endoscopy was performed in 1124 children, whereas 500 subjects underwent colonoscopy. Six-hundred-seven (54%) EGDs were positive, and 517 (46%) were negative, whereas 306 (61.1%) colonoscopies were positive, and 194 (38.9%) were negative. Of the 1624 procedures, 26% were considered inappropriate according to the Rome II criteria. Inappropriate procedures decreased significantly after publication of the Rome II criteria (OR, 3.7; 95% CI, 1.8-7.5). Of 1202 appropriate GI endoscopies, 502 EGD (62.7%) were significantly contributive, compared with only 105 (32.5%) of the 323 inappropriate procedures (OR, 3.5; 95% CI, 2.6-4.6;), whereas 265 (65.8%) colonoscopies were significantly contributive, compared with only 41 (42.3%) of the 97 inappropriate procedures (OR, 2.6; 95% CI, 1.6-4.1). Conclusions: The use of the criteria for FGIDs makes a significant positive impact in reducing unnecessary pediatric GI endoscopy.

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hal-00552583 , version 1 (06-01-2011)

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Erasmo Miele, Eleonora Giannetti, Massimo Martinelli, Antonella Tramontano, Luigi Greco, et al.. Impact of the Rome II Pediatric Criteria on the Appropriateness of the Upper and Lower Gastrointestinal Endoscopy in Children. Alimentary Pharmacology and Therapeutics, 2010, 32 (4), pp.582. ⟨10.1111/j.1365-2036.2010.04383.x⟩. ⟨hal-00552583⟩

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