The team assessed the utility and safety of gastrointestinal endoscopy in an extremely elderly cohort, and reported their findings in the July issue of Endoscopy.
214 consecutive participants, aged 85 years or more (median age = 87 years), were enrolled between 1995 and 1997.
Individuals were identified using a prospective database linked to the endoscopy reporting system.
Procedure type, indication, use of sedation, complications, and outcomes were all evaluated.
The researchers found that 185 patients had undergone one procedure, and 29 had undergone two or more. 65% of procedures were performed on an outpatient basis.
|Complications from endoscopy:|
Post-ERCP pancreatitis: 5%
Colonic perforation: 1%
Cardiopulmonary problems: 0.6%
Of the inpatient procedures, 10% of all procedures were performed emergently, predominantly for upper gastrointestinal hemorrhage.
Midazolam was administered to 129 patients (60%), at a median dose of 2 mg. Of these, 75 (35%) also received a median dose of 25 µg fentanyl.
Colonoscopy (n = 95) was found to be the most frequently performed procedure, followed by esophagogastroduodenoscopy (n = 64), and ERCP (n = 21).
There was no procedure-related mortality.
The incidence of post-ERCP pancreatitis was 5%. Colonic perforation and cardiopulmonary complications in sedated patients occurred in 1% and 0.6%, respectively.
The majority of the patients underwent procedures that related to active management of ongoing medical problems. Procedures were performed for palliative indications in only 15 (7%) patients.
Author G. A. Clarke, of the Brigham and Women's Hospital and Harvard University Medical School, concluded on behalf of the group, "Gastrointestinal endoscopy is very safe and well tolerated in extremely elderly patients. Age alone should not influence decisions relating to its utilization."