Alarm features for predicting significant endoscopic findings among patients with dyspepsia in Cameroon

Abstract

 Introduction: Dyspepsia is the major indication for gastroscopy in sub-Saharan Africa. However, endoscopic devices are not available in  rural areas, and the examination is invasive and expensive for the rural populations. The aim of this study is to assess the predictive value  of some alarm features in the prediction of endoscopic findings among adult patients with dyspepsia in Cameroon.

Materials and  Methods: We carried out a retrospective study using all reports of patients who underwent gastroscopy for dyspeptic syndrome from July  1 to December 31, 2021 at the Yaoundé General Hospital, Cameroon. We documented the sociodemographic characteristics, clinical  signs, the type of dyspepsia, and endoscopic findings. We also documented alarm features associated with significant pathology  (presence of an ulcer and/or a malignant tumor) at the endoscopy.

Results: Of the 310 gastroscopies, dyspeptic symptoms represented  226 indications (72.9%). There were 90 males (39.8%). The mean age was 46.4 ± 15.9 years (range 16–86). Signs associated with dyspepsia  were gastrointestinal (GI) bleeding in 8 patients (3.5%), weight loss in 6 patients (2.7%), and persistent vomiting in 13 patients (5.8%). A  significant endoscopy finding was observed among 53 patients (23.5%). On the univariate analysis, alarm features associated with a  significant lesion were male gender (P = 0.004), persistent vomiting (P = 0.047), and marginally for GI bleeding (P = 0.072). On the  multivariate analysis, only the male gender was significantly associated with the presence of a significant lesion (P = 0.024).

Conclusions:  Our results show that the male gender, GI bleeding, and persistent vomiting are alarm features associated with the presence of a  significant lesion among patients with dyspepsia.