Colonoscopy-related adverse events and mortality in an Italian organized colorectal cancer screening program.
Endoscopy
; 53(5): 501-508, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-32725616
ABSTRACT
BACKGROUND:
Post-colonoscopy adverse events are a key quality indicator in population-based colorectal cancer screening programs, and affect safety and costs. This study aimed to assess colonoscopy-related adverse events and mortality in a screening setting.METHODS:
We retrieved data from patients undergoing colonoscopy within a screening program (fecal immunochemical test every 2 years, 50-69-year-olds, or post-polypectomy surveillance) in Italy between 2002 and 2014, to assess the rate of post-colonoscopy adverse events and mortality. Any admission within 30 days of screening colonoscopy was reviewed to capture possible events. Mortality registries were also matched with endoscopy databases to investigate 30-day post-colonoscopy mortality. Association of each outcome with patient-/procedure-related variables was assessed using multivariable analysis.RESULTS:
Overall, 117â 881 screening colonoscopies (66â 584, 56.5â%, with polypectomy) were included. Overall, 497 (0.42â%) post-colonoscopy adverse events occurred 281 (0.24â%) bleedings (3.69/0.68, operative/diagnostic procedures) and 65 (0.06â%) perforations (0.75/0.29, respectively). At multivariable analysis, bleeding was associated with polyp size (≥â20 mm odds ratio [OR] 16.29, 95â% confidence interval [CI] 9.38-28.29), proximal location (OR 1.46, 95â%CI 1.14-1.87), and histology severity (high risk adenoma OR 5.6, 95â%CI 2.43-12.91), while perforation was associated with endoscopic resection (OR 2.91, 95â%CI 1.62-5.22), polyp size (OR 4.34, 95â%CI 1.46-12.92), and proximal location (OR 1.94, 95â%CI 1.12-3.37). Post-colonoscopy mortality occurred in 15â/117â 881 cases (1.27/10â000 colonoscopies).CONCLUSIONS:
In an organized screening program, post-colonoscopy adverse events were rare but not negligible. The most frequent event was post-polypectomy bleeding, especially after resection of large (≥â20âmm) and proximal lesions.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Detecção Precoce de Câncer
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália