A cross-sectional survey of patients ' compliance of endoscopic surveillance after endoscopic submucosal dissection / 中华消化内镜杂志

ABSTRACT

Objective:To investigate patients' compliance of endoscopic surveillance after endoscopic submucosal dissection (ESD) and the influencing factors.Methods:This study was a cross-sectional survey. The data of patients who underwent ESD in Xijing Digestive Hospital of Air Force Military Medical University from January 2014 to December 2015 were collected through questionnaire and telephone call. The questionnaire survey was conducted from May 1, 2019 to July 31, 2020. Patients' compliance for endoscopic surveillance and influencing factors were evaluated. Logistic regression model was used for multivariate analysis to determine independent risk factors affecting compliance of endoscopic surveillance.Results:A total of 413 questionnaires were collected, of which 331 (80.1%) patients were well complied with endoscopic surveillance, and 82 (19.9%) were not. Univariate analysis showed that gender ( χ2=4.68, P=0.034), lesion type ( χ2=10.10, P=0.002), educational background ( χ2=4.00, P=0.049), disposable income ( χ2=7.00, P=0.009), employment ( χ2=11.29, P=0.004) and medical insurance ( χ2=13.59, P=0.001) affected patients' endoscopic surveillance compliance. Logistic regression analysis indicated that patients with submucosal lesions were less likely to be compliant than patients with mucosal lesions with the same type of medical insurance ( P<0.001, OR=0.383, 95% CI 0.227-0.644); and with the same lesion type, patients with urban medical insurance were more likely to be compliant than those with rural cooperative medical insurance ( P<0.001, OR=2.938, 95% CI 1.696-5.090). Conclusion:The endoscopic surveillance compliance for post-ESD patients is related to the lesion type, the type of medical insurance, and the awareness of the disease. More attention should be paid to those with submucosal lesions and rural cooperative medical insurance due to their poor compliance. And it is necessary to improve health education on the disease for better surveillance compliance.