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 24 June 2017

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News

Non-GI adverse events after outpatient colonoscopy in high-risk patients

The most recent issue of the Clinical Gastroenterology & Hepatology reports an increased post-procedural non-gastrointestinal adverse events after outpatient colonoscopy in high-risk patients.

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The incidence and predictors of non-gastrointestinal (GI) adverse events after colonoscopy are not well-understood. We studied the effects of antithrombotic agents, cardiopulmonary comorbidities, and age on risk of non-GI adverse events after colonoscopy.

Dr David Johnson and colleagues from the United Kingdom performed a retrospective longitudinal analysis to assess the diagnosis, procedure, and prescription drug codes in a United States commercial claims database. 

Data from patients at increased risk were compared with data from 398,663 average-risk patients. 

In a 1:1 matched analysis, 51,932 patients at increased risk, examined by colonoscopy, were compared with 51,932 matched patients at increased risk who did not undergo colonoscopy. 

Older age is associated with increased risk of non-GI adverse events after colonoscopy
Clinical Gastroenterology & Hepatology
The researchers tracked cardiac, pulmonary, and neurovascular events 1–30 days after colonoscopy.

The research team found that 30 days after outpatient colonoscopy, non-GI adverse events were significantly higher in patients taking antithrombotic medications or those with pulmonary comorbidities vs average-risk patients, and in patients 60–69 years old or 70 years or older, compared with patients younger than 50 years. 

The team observed that the 30-day incidence of non-GI adverse events in patients at increased risk who underwent colonoscopy was also significantly higher than in matched patients at increased risk who did not undergo colonoscopy in the anticoagulant group, and in the chronic obstructive pulmonary disease group.

Dr Johnson's team comments, "Increased number of comorbidities and older age are associated with increased risk of non-GI adverse events after colonoscopy."

"These findings indicate the importance of determining comorbid risk and evaluating antithrombotic management before colonoscopy."

Clin Gastroenterol Hepatol 2017: 15(6): 883–891.e9 
16 June 2017

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