Anna Forsberg1, Ulf Hammar2, Anders Ekbom1, Rolf Hultcrantz3. 1. a Department of Medicine Solna , Karolinska Institutet , Stockholm , Sweden. 2. b Department of Biostatistics , Institute of Environmental Medicine, Karolinska Institutet , Stockholm , Sweden. 3. c Department of Medicine, Division of Gastroenterology , Huddinge Hospital, Karolinska Institutet , Stockholm , Sweden.
Abstract
OBJECTIVES: The rates for colonoscopy-associated adverse events vary considerably worldwide. In Sweden, the figures are known to a limited extent. We assessed the frequency of severe colonoscopy-related adverse events and the impacts of different risk factors, including the use of general anaesthesia. MATERIAL AND METHODS: This is a retrospective population-based cohort study of the colonoscopies performed during the years 2001-2013 on adults identified in the Swedish health registers. The rates for bleeding, perforation, splenic injury and 30-day mortality were calculated. Covariates for risks were assessed in a multivariate Poisson regression model. RESULTS: There were 593,315 colonoscopies performed on the 426,560 individuals included in the study. The rates for colonoscopy-related bleeding and perforation were 0.17% and 0.11%, respectively. When polypectomy was performed, the rates were 0.53% for bleeding and 0.25% for perforation. There were 31 splenic injuries (1:20,000 colonoscopies) reported. The crude 30-day death rate for colonoscopy was 0.68%. Of those diagnosed with bleeding or perforation, 5.6% and 6.1% were dead within 30 days, respectively. The multivariate RR for perforation when general anaesthesia was employed was 2.65 (p < .001; 95%CI 1.71-4.12). CONCLUSIONS: The perforation rate seemed to be relatively high in an international perspective. General anaesthesia was associated with a significantly higher risk for perforation. Splenic injuries were more frequent than expected.
OBJECTIVES: The rates for colonoscopy-associated adverse events vary considerably worldwide. In Sweden, the figures are known to a limited extent. We assessed the frequency of severe colonoscopy-related adverse events and the impacts of different risk factors, including the use of general anaesthesia. MATERIAL AND METHODS: This is a retrospective population-based cohort study of the colonoscopies performed during the years 2001-2013 on adults identified in the Swedish health registers. The rates for bleeding, perforation, splenic injury and 30-day mortality were calculated. Covariates for risks were assessed in a multivariate Poisson regression model. RESULTS: There were 593,315 colonoscopies performed on the 426,560 individuals included in the study. The rates for colonoscopy-related bleeding and perforation were 0.17% and 0.11%, respectively. When polypectomy was performed, the rates were 0.53% for bleeding and 0.25% for perforation. There were 31 splenic injuries (1:20,000 colonoscopies) reported. The crude 30-day death rate for colonoscopy was 0.68%. Of those diagnosed with bleeding or perforation, 5.6% and 6.1% were dead within 30 days, respectively. The multivariate RR for perforation when general anaesthesia was employed was 2.65 (p < .001; 95%CI 1.71-4.12). CONCLUSIONS: The perforation rate seemed to be relatively high in an international perspective. General anaesthesia was associated with a significantly higher risk for perforation. Splenic injuries were more frequent than expected.
Entities:
Keywords:
Register based; adverse events; anaesthesia; colonoscopy; national population study
Authors: Torbjörn Thulin; Ulf Hammar; Anders Ekbom; Rolf Hultcrantz; Anna M Forsberg Journal: United European Gastroenterol J Date: 2018-10-23 Impact factor: 4.623
Authors: Mathias M Petersen; Linnea Ferm; Jakob Kleif; Thomas B Piper; Eva Rømer; Ib J Christensen; Hans J Nielsen Journal: Cancers (Basel) Date: 2020-09-12 Impact factor: 6.639