全球范围内对结肠镜检查的需求不断增长，导致不适当转诊率增加。结肠镜检查的这种“过度使用”已成为医疗保健的主要负担。评估苏塞大学医院内窥镜检查室进行的结肠镜检查的适当性，并根据欧洲胃肠内窥镜检查适当性小组比较这些适当性结果（ EPAGE) I 和 EPAGE II 标准。这项横断面研究包括 2017 年 1 月至 2018 年 12 月期间转诊进行诊断性结肠镜检查的所有连续患者。仅因治疗适应症转诊的患者，不包括结肠镜检查不完整的患者。肠道准备不良或数据缺失的患者也被排除在外。使用 EPAGE I 和 EPAGE II 标准评估适应症。从 1972 名连续患者中，纳入了 1307 名患者。总体而言，所有转诊中有 986 例（75.4%）是门诊患者。大多数患者由胃肠病专家转诊（n = 1026 名患者；78.5%），其次是普通外科医生（n = 85；6.5%）。最常见的适应症是下腹部症状（275；21%），其次是无并发症的腹泻（152；11.6%）。 363 名患者（27.7%）有相关发现。 221 名患者 (16.9%) 的主要发现是肿瘤病变。 EPAGE I和EPAGE II标准分别适用于1237例（88.8%）和1276例（97.7%）患者。根据两组标准，便血和腹痛的不适当率最高。当应用 EPAGE II 标准时，适当的结肠镜检查增加到 76.4%；而不确定和不适当的程序分别下降至 10.3% 和 10.9%。住院患者的适应症适当性显着更高。对于 EPAGE II 标准，转诊医生的专业也与适当的使用显着相关。使用 k 的加权版本 (k = 0.153)，EPAGE I 和 EPAGE II 标准之间的一致性很小。更新和改进的 EPAGE II 指南是评估结肠镜检查适当性的简单而有效的工具。他们降低了不适当率和漏诊潜在严重诊断的可能性。© 2024。作者。

There is a growing demand for colonoscopy, worldwide, resulting in increased rate of inappropriate referrals. This "overuse" of colonoscopies has become a major burden for health care.to assess the appropriateness of colonoscopies performed at the endoscopy unit of the university hospital of Sousse and to compare these results of appropriateness according to the European Panel of Appropriateness of Gastrointestinal Endoscopy (EPAGE) I and EPAGE II criteria.this cross-sectional study included all consecutive patients referred for a diagnostic colonoscopy, between January 2017 and December 2018. Patients referred for exclusively therapeutic indications, those with incomplete colonoscopies were not included. Patients with poor bowel preparation or missing data were also excluded. Indications were assessed using the EPAGE I and EPAGE II criteria.From 1972 consecutive patients, 1307 were included. Overall, 986 (75.4%) of all referrals were for out-patients. The majority of patients were referred by gastroenterologists (n = 1026 patients; 78.5%), followed by general surgeons (n = 85; 6.5%). The commonest indications were lower abdominal symptoms (275; 21%) followed by uncomplicated diarrhea (152; 11.6%). Relevant findings were present in 363 patients (27.7%). Neoplastic lesions were the dominant finding in 221 patients (16.9%). EPAGE I and EPAGE II criteria were applicable for 1237 (88.8%) and 1276 (97.7%) patients respectively. Hematochezia and abdominal pain recorded the highest inappropriate rates with both sets of criteria. Appropriate colonoscopies increased to 76.4% when EPAGE II criteria were applied; whereas uncertain and inappropriate procedures decreased to 10.3% and 10.9% respectively Appropriateness of indication was significantly higher in hospitalized patients. For the EPAGE II criteria, the specialty of the referring physician was also significantly associated to the appropriate use. The agreement between EPAGE I and EPAGE II criteria was slight using the weighted version of k (k = 0.153).The updated and improved EPAGE II guidelines are a simple and valid tool for assessing the appropriateness of colonoscopies. They decreased the inappropriate rate and the possibility of missing potentially severe diagnoses.© 2024. The Author(s).