Improving Quality and Safety in the Endoscopy Unit (On-Demand)

ASGE Adverse Events EGD

Pdf Summary

This guideline document, prepared by the American Society for Gastrointestinal Endoscopy (ASGE), provides an overview of the adverse events (AEs) associated with esophagogastroduodenoscopy (EGD) and related techniques. Its purpose is to inform endoscopists on the rates and predictors of AEs, providing evidence-based and updated information to patients and healthcare professionals. Although EGD is a commonly performed and generally safe procedure in the United States, the increasing complexity of cases and advancing related techniques necessitate an updated review of potential risks.<br /><br />The document outlines five primary types of AEs associated with EGD, including bleeding, perforation, infection, and cardiopulmonary complications. Key highlights about these AEs include their low incidences: <br />- **Bleeding** is rare (.1% for diagnostic EGD), with higher rates in patients with conditions like Barrett’s esophagus or malignancies.<br />- **Perforation** occurs at an extremely low rate (.01% to .7% for various types of EGD).<br />- **Infections**, such as aspiration pneumonia, occur in less than .3% of cases.<br />- **Cardiopulmonary AEs**, though serious, are uncommon, with risks influenced by conditions like obesity and coronary artery disease.<br /><br />Other specific EGD-related procedures, such as those involving foreign body management, dilation, stent placement, and PEG/PEJ, have their distinct AE profiles. For instance, pneumatic dilation has a higher risk of perforation (2% to 5%), and stent placement can lead to migration and occlusion issues.<br /><br />The guidelines also stress the importance of understanding patient and procedure-level predictors of AEs to improve outcomes and guide clinical decision-making. Ongoing research and data collection are suggested to further elucidate risks associated with newer endoscopic techniques. These insights are crucial to tailoring the procedure to individual patient needs, optimizing the informed consent process, and enhancing overall patient care in gastroenterology.

Keywords

American Society for Gastrointestinal Endoscopy

adverse events

esophagogastroduodenoscopy

EGD

bleeding

perforation

infection

cardiopulmonary complications

endoscopic techniques

patient care