The effect of pre-procedural anxiety level on the quality of upper GI endoscopy in non-sedated patients: “can the need for sedation be predicted?”
Background: Pre-procedural anxiety is known to impact the quality of upper gastrointestinal endoscopy (esophagogastroduodenoscopy, EGD), particularly in non-sedated patients. Elevated anxiety levels can cause discomfort and reduce procedural success. Objectives: This study aimed to evaluate the effe...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2025-04-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848251333025 |
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| Summary: | Background: Pre-procedural anxiety is known to impact the quality of upper gastrointestinal endoscopy (esophagogastroduodenoscopy, EGD), particularly in non-sedated patients. Elevated anxiety levels can cause discomfort and reduce procedural success. Objectives: This study aimed to evaluate the effect of pre-procedural anxiety, measured by the State-Trait Anxiety Inventory (STAI), on the quality of EGD and to determine whether anxiety levels can predict the need for sedation. Design: This was a prospective, cross-sectional study conducted at a tertiary care hospital. Methods: This study included 1344 non-sedated patients aged 18–90 years undergoing EGD at Ankara Etlik City Hospital (September 2023–March 2024). Anxiety levels were assessed using STAI before the procedure. Receiver operating characteristic (ROC) analysis determined the optimal STAI-I cutoff for predicting sedation needs. EGD quality was evaluated by examination thoroughness and biopsy adequacy. Logistic regression identified predictors of unsuccessful procedures. Results: The mean participant age was 50.6 years; 47.8% were male. The average STAI-I score was 42.14. ROC analysis identified an STAI-I cutoff of 36, above which unsuccessful procedures were more likely (area under the curve = 0.720, p < 0.001). Higher STAI-I and STAI-II scores were independent predictors of unsuccessful endoscopy, with each unit increase in STAI-I raising the odds by 3.8%. Conclusion: Pre-procedural anxiety, as measured by STAI, significantly affects non-sedated EGD quality. An STAI-I cutoff of 36 predicts the need for sedation. Routine anxiety assessment could enhance sedation strategies, patient satisfaction, and procedure quality. Trial registration : Not applicable. |
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| ISSN: | 1756-2848 |