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 20 February 2018

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News

Risk factors for bleeding or perforation after outpatient colonoscopy

This month’s Gastroenterology evaluates bleeding and perforation after outpatient colonoscopy and their risk factors in usual clinical practice.

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The most widely quoted complication rates for colonoscopy are from case series performed by expert endoscopists.

Dr Linda Rabeneck and colleagues from Canada evaluated the rates of bleeding, perforation, and death associated with outpatient colonoscopy and their risk factors in a population-based study.

The team identified all individuals 50 to 75 years old who underwent an outpatient colonoscopy during 2002 to 2003, in British Columbia, Alberta, Ontario, and Nova Scotia, Canada.

The research team used administrative data to identify all individuals who were admitted to hospital with bleeding or perforation within 30 days following the colonoscopy in each province.

The team calculated the pooled rates of bleeding and perforation from the 4 provinces.

The team abstracted the hospital charts of all deaths that occurred within 30 days following the procedure.

The team used generalized estimating equations models to evaluate factors associated with bleeding and perforation.

The pooled rates of colonoscopy-related bleeding was 1.6 per 1000
Gastroenterology

The researchers identified 97,091 persons who had an outpatient colonoscopy.

The pooled rates of colonoscopy-related bleeding and perforation were 1.6 per 1000 and 0.9 per 1000, respectively.

The death rate was 0.07 per 1000 or approximately 1 per 14,000.

Older age, male sex, having a polypectomy, and having the colonoscopy performed by a low-volume endoscopist were associated with increased odds of bleeding or perforation.

Dr Rabeneck’s team concluded, “Although colonoscopy has established benefits for the detection of colorectal cancer and adenomatous polyps, the procedure is associated with risks of serious complications, including death.”

“Older age, male sex, having a polypectomy, and having the procedure done by a low-volume endoscopist were independently associated with colonoscopy-related bleeding and perforation.”

Gastroenterol 2008: 135(6): 1899-1906


16 December 2008

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