Complications of pediatric EGD: a 4-year experience in PEDS-CORI

BackgroundAvailable estimates of the incidence and type of complications during pediatric EGD are inconsistent.ObjectiveTo determine the frequency and the determinants of immediate complications during EGD in children.DesignWe conducted a cross-sectional database study.SettingThe study involved 13 pediatric facilities that use the PEDS-CORI (Pediatric Endoscopy Database System Clinical Outcomes Research Initiative).PatientsChildren (0-18 years) who underwent EGD at 13 facilities between November 1999 and December 2003.Main Outcome MeasurementsWe identified complications (recorded shortly after the procedure) and analyzed their occurrence with respect to procedure indication, American Society of Anesthesiologists (ASA) class, sex, age, anesthesia type, and unplanned interventions.ResultsWe analyzed 10,236 procedures performed in 9234 patients. Immediate complications were reported in 239 procedures (2.3%, 95% confidence interval 2.0%-2.6%). The most common complications were hypoxia (157 [1.5%]) and bleeding (28 [0.3%]). Complication rates were significantly higher in the youngest age group, highest ASA class, female gender, intravenous (IV) sedation group, and in the presence of a fellow.LimitationsThe study is limited by a lack of specific details and explicit criteria for reported complications.ConclusionsThe overall immediate complication rate of pediatric EGD is 2.3%. All complications were nonfatal, and most were hypoxia related (157/239 [66%]) and reversible. Young age, higher ASA class, female sex, and IV sedation are risk factors for developing complications.