A Multicenter Evaluation of the Utilization of Endoscopic Ultrasound

ABSTRACT

Objectives

There are currently no data regarding the number and type of EUS procedures being performed in the United States. The aims of the study are to: 1) estimate the annual number of EUS procedures being performed in a nationwide database, 2) describe the indications and type of EUS performed, and 3) examine short-term trends in volume.

Methods

Retrospective analysis from the Clinical Outcomes Research Initiative (CORI) of EUS procedures performed on patients > 18 years of age from January 1, 2010 through December 31, 2013.

Results

7,614 EUS cases were performed by 68 endoscopists at 18 sites over the study period, representing 1.7% of the total number of endoscopic procedures. The most common indications were evaluation of a pancreatic mass (14.7%), diagnostic sampling with fine needle aspiration (14.1%), and evaluation of a pancreatic cyst (14.0%). The number of EUS examinations and cases undergoing same day ERCP increased over the study period (p < 0.0001). Use of general anesthesia or deep sedation increased markedly from 37.8% to 82.8% of procedures (p < 0.0001).

Conclusions

This is the largest survey of EUS practice in the United States. Evaluation of the pancreas accounts for roughly 40% of the indications for EUS. Use of EUS increased over the study period, and the proportion performed with deep sedation or general anesthesia increased as well. These data may have implications regarding number of endosonographers who should be trained, as well as cost issues pertaining to increasing use of anesthesia providers and same-day ERCP.

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