Koloskopie und Sigmoidoskopie bei über achtzigjährigen Patienten

Kirchgatterer, A; Hübner, Dietmar; Aschl, G; Hinterreiter, M; Stadler, Bärbel M. R.; Knoflach, P

doi:10.1055/s-2002-36157

Cited by 13 publications

(2 citation statements)

References 3 publications

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“…Similar to Cha et al, 9 we found that increasing age alters the indications for colonoscopy because nonagenarians were more likely to undergo colonoscopy due to rectal bleeding, anemia, and following an episode of volvulus, and less likely for polyp surveillance. As opposed to other studies, 12 we found that most of the nonagenarians were successfully and safely sedated and had a low procedurerelated complication rate. Nonagenarians were more likely to be sedated by fentanyl and propofol, to receive general anesthesia, and altogether needed lower medication doses compared with octogenarians.…”

Section: Discussioncontrasting

confidence: 99%

Colonoscopy in Nonagenarians Is Safe and May Be Associated with Clinical Benefit

Shafrir

Koslowsky

Wengrower

et al. 2019

J American Geriatrics Society

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OBJECTIVES Data regarding colonoscopy in patients older than 90 years old is scarce. Yet the number of colonoscopies done on nonagenarians is rising. We aimed to determine the yield, safety, and therapeutic benefits of colonoscopy in these patients. DESIGN Case‐control study of older patients who underwent colonoscopy. SETTING Gastroenterology institute at an academic medical center. PARTICIPANTS Patients older than 90 years (n = 128) compared with patients aged 80 to 89 years (n = 218) who underwent colonoscopy. INTERVENTION Colonoscopy. MEASUREMENTS Indication for the procedure, completion rates, adequacy of preparation, complications, colonoscopic findings, 30‐day mortality, advanced adenoma and carcinoma detection rate, treatment, and long‐term survival of patients diagnosed with colorectal cancer. RESULTS Mean ages were 83.3 and 92.2 years old. Nonagenarians were more likely to undergo a colonoscopy while hospitalized (56.2 vs 23.4%; P < .001) and to undergo the examination due to rectal bleeding or sigmoid volvulus (35.2 vs 25.2 and 10.9 vs 0.5%, respectively; P < .001) and less likely for surveillance or constipation (11.7 vs 25.7 and 0 vs 6.9%, respectively; P < .001). Completion rates and severe adverse events were comparable. The 30‐day mortality was 3.9% in nonagenarians and 0.4% in octogenarians (P = .02). Advanced adenomas and carcinoma were more common in nonagenarians (25.8 vs 16.5%, P = .03, and 14.8 vs 6.4%, P = .01, respectively). Increasing age, inpatient status, past polypectomy surveillance, and anemia were associated with higher rates of carcinoma. Half of the nonagenarians diagnosed with adenocarcinoma underwent surgery compared with 100% of octogenarians (P = .01). Among nonagenarians with colorectal cancer who died, mean survival was 605 (interquartile range = 11‐878) days in those who underwent surgery and 112 (48‐341) in those treated conservatively (P = .055 log‐rank test). CONCLUSION Colonoscopy in nonagenarians has a high yield and is generally safe. Colonoscopy findings lead to surgery in more than half of these patients and was associated with a median survival of 20 months.

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Section: Discussioncontrasting

confidence: 99%

Colonoscopy in Nonagenarians Is Safe and May Be Associated with Clinical Benefit

Shafrir

Koslowsky

Wengrower

et al. 2019

J American Geriatrics Society

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“…Realization of a colonoscopy is the principal diagnostic test and in many cases is also the main important therapy in this group of patients [6]. Although this procedure is safe, it generally only shows known and expected findings, especially in old patients [7].…”

Section: Introductionmentioning

confidence: 99%

Survival Analysis of Geriatric Patients with Low Digestive Hemorrhage Attending an Emergency Department

Fernandez-Suárez

Torres

2021

Gerontology

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Background: The increase in life expectancy and low mortality have doubled the number of individuals older than 65 in the last 30 years. Methods: We conducted a retrospective study of 101 patients older than 80 years of age treated by low digestive hemorrhage (LDH) in an emergency department during 2018. Sociodemographic variables were evaluated, as well as comorbidity and survival at 18 months. Survival was assessed by a Kaplan-Meier test. Results: 52.5% of the subjects were women. The average comorbidity of the sample was 1.97. The survival rate per year was 60%. The finding on colonoscopy shows no association with mortality. However, those patients on anticoagulant/antiplatelet therapy have a higher survival rate. Conclusion: Survival per year is high, so urgent colonoscopy for an LDH should be performed after evaluating the patient’s stability and functional status in a scheduled and outpatient manner.

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Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography

et al. 2004

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The purpose was to evaluate supine/left decubitus as an alternative to supine/prone scanning in computed tomographic colonography (CT colonography). Fifty patients were randomised to supine/prone, another 50 to supine/left decubitus scanning. Patients were scanned using a single-slice CT scanner. The colon was divided into eight segments. Comparisons of distension, breathing artefacts, residus and polyp detection were made between the two groups as well as between the different positions. Adequate distension was found in approximately 85, 97 and 95% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased the percentage of adequate distension to 98.5% for prone-supine and 97.7% for left decubitus-supine scanning ( P<0.0005 compared to supine, P=0.001 compared to left decubitus and P=0.046 compared to prone scanning). Absence of residual material was found in approximately 62.7, 69.7 and 64% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased this percentage to approximately 99% for both groups. No significant differences towards distension or residual material were found between combined supine-prone or supine-left decubitus scanning. In the supine-prone group, combined scanning additionally revealed four lesions and improved conspicuity in two cases of stalked polyps. In the supine-left decubitus group, combined scanning additionally revealed two lesions and improved conspicuity in one stalked polyp. There were significantly fewer breathing artefacts with left decubitus scanning than prone scanning ( P=0.005). A strong positive correlation was found between breathing artefacts and the age of patients in both patient groups. Colonic distension and preparation is improved by using supine and prone or supine and left decubitus scanning in combination, with a subsequent improved polyp detection. There were no significant differences between the two scanning protocols. Prone scanning, however, is hampered by breathing artefacts, especially in the elderly. Therefore, supine-left decubitus scanning is considered a valuable alternative to supine-prone scanning for the elderly.

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Koloskopie und Sigmoidoskopie bei über achtzigjährigen Patienten

Cited by 13 publications

References 3 publications

Colonoscopy in Nonagenarians Is Safe and May Be Associated with Clinical Benefit

Colonoscopy in Nonagenarians Is Safe and May Be Associated with Clinical Benefit

Survival Analysis of Geriatric Patients with Low Digestive Hemorrhage Attending an Emergency Department

Supine/left decubitus scanning: a valuable alternative to supine/prone scanning in CT colonography

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