Low Rates of Gastrointestinal and Non-Gastrointestinal Complications for Screening or Surveillance Colonoscopies in a Population-Based Study

Abstract

In a population-based study in California, we found that following S-colo, rates of serious GI adverse events were low but clinically relevant, and that rates of myocardial infarction, stroke, and serious pulmonary events were no higher than after low-risk comparator procedures. Rates of myocardial infarction are similar to, but rates of stroke are higher than, those reported for the general population.

Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA

“…One study based on all-payer claims of California between 2005 and 2011 investigated the rate of pneumonia and bacteraemia after colonoscopy 20. They identified a 7-day pneumonia rate of 2.7–4.4 per 10 000 procedures that was comparable with our estimate of 2.9–3.0 in 2014.…”

“…Our study shares the general limitations of claims-based research, such as flaws in billing codes and limited clinical details to determine causality. The procedure codes for sedation (CPT codes: 00810, 99 143–99145, 99 148–99150) was only coded in 1.0% of colonoscopy and 0.9% of OGD cases, so we were not able to study the impact of sedation on infection rates in most states, a limitation shared by another study using the same database 20. It is difficult to prove a definite causal relationship between the endoscopic procedures and infections without individual case investigation and microbiological testing of the endoscopes and facility environment.…”

Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society

“…The comparable perforation rates were 3 per 10,000 and 6 per 10,000, respectively. Thirty‐day non‐GI complications were reassuringly low in that study; the risk of myocardial infarction was 2.5 per 10,000 for colonoscopy without biopsy and 4 of 10,000 with biopsy, which was lower than that for comparator procedures (joint aspiration/injection and lithotripsy) …”

“…The principal recognized harms of CRC screening, which are rare, are those associated with colonoscopy (bleeding, perforation, cardiorespiratory complications of sedation) as a primary screening test or as a follow-up of other positive noncolonoscopy tests. 26,40,41 The harm conventionally associated with workup of false-positive test results is partly mitigated when a normal follow-up examination removes the patient from the screening pool for 10 years. In addition to estimating the number of colonoscopy-related complications, the CISNET modeling group used the number of colonoscopies required as a proxy for harms and a measure of the burden of CRC screening.…”

PRO: This Patient Should Have a Liver Biopsy

“…The most serious complication that can occur is death, usually from hemorrhage; this is quite rare at 1 in 10,000 . Again, the risk for dying from a screening colonoscopy (1 in 3125) or a simple outpatient surgery such as cataract repair (1 in 1590) is much higher.…”