Abstract

PINEDA O, Luis Fernando et al. Enfermedad estructural y valor predictivo de la historia clínica en pacientes con dispepsia no investigada. Rev Col Gastroenterol [online]. 2004, vol.19, n.1, pp.13-25. ISSN 0120-9957.

Objective. We sought to determine the prevalence of underlying diseases in patients with uninvetigated dyspepsia by endoscopy and the discriminant value of alarm features. Methods. Patients with uninvestigated dyspepsia sent to endoscopy units of 4 hospital in Bogota underwent a specifically designed questionnaire before the procedure, datas were collected prospectively; dyspepsia was defined as pain or discomfort in the upper abdomen and during endoscopy the organic causes of dyspepsia were registered (peptic ulcer, reflux esophagitis, gastroesophageal malignancies or benign stricture). We performed a stepwise logistic regression analyses with the clinical variables and the endoscopic findings to determine the value of the alarm features in the prediction of organic dyspepsia. Results. 542 patients mean age 42 yr ( +/- 16.2yr), 67% females, 31% with alarm features were studied. The endoscopic findings in this sample were: peptic ulcer 13.7%, gastric cancer 9%, reflux esophagitis 5.9%. 73% of patients were considered Non-ulcer dyspepsia. Organic dyspepsia was related significantly with sex (male 53.4% vs females 24.7% p < 0.01), old age and alarma features 50.7% vs 23.7%, p<0.001) however among 50 cases of cancer 6 (12%) were younger than 45 yr and there were 9 (18%) without alarm features, the values of sensitivity, specificity PPV and NPV in this sample were 50.7%, 76.3%, 44.0% and 80% respectively. Conclusion. In Bogota Colombia gastric cancer is the second cause of dyspepsia; age and alarms features have a limited role in the prediction of organic causes of dyspepsia, we recommend endoscopy in every patient 30 year or older with uninvestigated dyspepsia in our community.

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