An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield

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dc.contributor.advisorSetshedi, Mashiko
dc.contributor.authorKaskar, Nabeal
dc.date.accessioned2026-10-19T10:06:58Z
dc.date.available2026-10-19T10:06:58Z
dc.date.issued2026
dc.date.updated2026-10-16T09:59:04Z
dc.description.abstractBackground: Oesophagogastroduodenoscopy (OGD) remains the gold standard for evaluating upper gastrointestinal (GI) symptoms, yet inappropriate referrals, especially in resource-limited settings, strain healthcare systems. In South Africa, the burden of GI disease is compounded by socioeconomic factors and high rates of infectious diseases and malignancies. Objective: To assess the demographic characteristics, clinical indications, and diagnostic yield of upper GI endoscopies performed at a tertiary hospital in Cape Town over a nine-year period. Methods: A retrospective, descriptive study was conducted using data from 10,221 adult patients who underwent OGD between January 2014 and June 2023 at Groote Schuur Hospital. Indications and endoscopic findings were analyzed using standard statistical methods. Results: The majority of patients were over 45 years (70.7%) and female (58.8%). Dyspepsia (46.9%), anaemia, and upper GI bleeding were the most common indications. Overall, 72% of OGDs revealed abnormal findings, with gastritis being most prevalent. Malignancies were uncommon, with gastric and oesophageal cancer identified in 0.9% and 0.62% of cases, respectively. Diagnostic yield was significantly higher in patients over 45 and those presenting with anaemia, vomiting, or GI bleeding. Younger patients had higher rates of normal findings and oesophageal varices. Conclusions: The study highlights the high diagnostic yield of OGD when guided by appropriate indications, particularly in older patients and those with alarm symptoms. Improved triage, guideline adherence, and preventive strategies are essential for optimizing endoscopy services in resource-constrained environments. Future research should focus on outcomes of targeted interventions, including H. pylori eradication and liver disease screening.
dc.identifier.apacitationKaskar, N. (2026). <i>An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/43886en_ZA
dc.identifier.chicagocitationKaskar, Nabeal. <i>"An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2026. http://hdl.handle.net/11427/43886en_ZA
dc.identifier.citationKaskar, N. 2026. An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield. . University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/43886en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kaskar, Nabeal AB - Background: Oesophagogastroduodenoscopy (OGD) remains the gold standard for evaluating upper gastrointestinal (GI) symptoms, yet inappropriate referrals, especially in resource-limited settings, strain healthcare systems. In South Africa, the burden of GI disease is compounded by socioeconomic factors and high rates of infectious diseases and malignancies. Objective: To assess the demographic characteristics, clinical indications, and diagnostic yield of upper GI endoscopies performed at a tertiary hospital in Cape Town over a nine-year period. Methods: A retrospective, descriptive study was conducted using data from 10,221 adult patients who underwent OGD between January 2014 and June 2023 at Groote Schuur Hospital. Indications and endoscopic findings were analyzed using standard statistical methods. Results: The majority of patients were over 45 years (70.7%) and female (58.8%). Dyspepsia (46.9%), anaemia, and upper GI bleeding were the most common indications. Overall, 72% of OGDs revealed abnormal findings, with gastritis being most prevalent. Malignancies were uncommon, with gastric and oesophageal cancer identified in 0.9% and 0.62% of cases, respectively. Diagnostic yield was significantly higher in patients over 45 and those presenting with anaemia, vomiting, or GI bleeding. Younger patients had higher rates of normal findings and oesophageal varices. Conclusions: The study highlights the high diagnostic yield of OGD when guided by appropriate indications, particularly in older patients and those with alarm symptoms. Improved triage, guideline adherence, and preventive strategies are essential for optimizing endoscopy services in resource-constrained environments. Future research should focus on outcomes of targeted interventions, including H. pylori eradication and liver disease screening. DA - 2026 DB - OpenUCT DP - University of Cape Town KW - Oesophagogastroduodenoscopy (OGD) KW - Gastroscopy KW - Dysphagia KW - Gastritis KW - Hiatus Hernia KW - Barrett's Oesophagus KW - Gastro-oesophageal reflux disease LK - https://open.uct.ac.za PB - University of Cape Town PY - 2026 T1 - An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield TI - An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield UR - http://hdl.handle.net/11427/43886 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/43886
dc.identifier.vancouvercitationKaskar N. An audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield. []. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2026 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/43886en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectOesophagogastroduodenoscopy (OGD)
dc.subjectGastroscopy
dc.subjectDysphagia
dc.subjectGastritis
dc.subjectHiatus Hernia
dc.subjectBarrett's Oesophagus
dc.subjectGastro-oesophageal reflux disease
dc.titleAn audit of the gastroscopy service at a tertiary hospital to determine the appropriateness of indication and yield
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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