Elsevier

Gastrointestinal Endoscopy

Volume 50, Issue 3, September 1999, Pages 322-328
Gastrointestinal Endoscopy

Prospective analysis of complications 30 days after outpatient colonoscopy,☆☆,,★★

Presented at the annual meeting of the American College of Gastroenterology May, 1997, Chicago, Illinois, and poster presentation at Digestive Disease Week, May 17-20, 1998, New Orleans, Louisiana.
https://doi.org/10.1053/ge.1999.v50.97111Get rights and content

Abstract

Background: Our objective was to (1) determine whether more complications are reported by patients 30 days after outpatient colonoscopy than are discussed at our monthly morbidity and mortality conferences, (2) identify complications resulting in visits to the emergency department or physician's office or leading to hospitalization, and (3) assess which factors put patients at highest risk. A secondary goal was to determine the rate of work lost after outpatient colonoscopy. Methods: Trained interviewers performed standardized telephone interviews of consecutive outpatients undergoing colonoscopy at Georgetown University Hospital over a 1-year period. Results: One thousand one hundred ninety-six patients were contacted 30 days after outpatient colonoscopy and participated in our study. Twenty patients had complications that required a visit to an emergency department or physician. Ninety percent of these cases (18) were detected at 30 days, but 15% (3) were discussed at morbidity and mortality conferences. All seven complications that necessitated hospitalization were identified at 30 days, but only two were discussed at our morbidity and mortality conference. The most common complications reported by patients were abdominal discomfort (5.4%) and rectal bleeding (2.1%). Conclusion: More complications are detected by means of contacting patients 30 days after outpatient colonoscopy than are discussed at our morbidity and mortality conferences. (Gastrointest Endosc 1999;50:322-8.)

Section snippets

PATIENTS AND METHODS

The cohort was composed of patients undergoing outpatient colonoscopy at Georgetown University Hospital from January 14, 1997, to January 13, 1998. All patients were interviewed by telephone 30 days after the procedure regarding possible endoscopic complications and work lost. Twenty physicians performed colonoscopy in the endoscopy suite. Nine physicians were academic gastroenterologists, seven were gastroenterologists in private practice, two were pediatric academic gastroenterologists, and

RESULTS

One thousand six hundred twenty-one patients underwent outpatient colonoscopy from January 14, 1997, to January 13, 1998. Of these patients, 1196 (74%) were contacted and agreed to participate in the study. The average age of the patients contacted was 56.7 years, and 53% were men. The most common reason for exclusion was no answer at the telephone number given. Five patients died before the end of the 30-day follow-up period, but none of the deaths was procedure related. One hundred

DISCUSSION

Contacting patients 30 days after outpatient colonoscopy identified significantly more complications than were discussed at monthly morbidity and mortality conferences. Most complications detected at 30 days occurred within 48 hours of the procedure and did not necessitate additional medical attention. However, most emergency department or physician visits and hospitalizations resulting from colonoscopy were detected at 30 days but were not discussed at morbidity and mortality conferences; the

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From the Department of Gastroenterology, Georgetown University Hospital, Washington, DC, and Gastroenterology Section, Veterans Affairs Medical Center, Memphis, Tennessee.

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Supported by a grant from the American College of Gastroenterology.

Reprint requests: Richard Zubarik, 8987 Shady Leaf Cove, Cordova, TN 38018; e-mail: [email protected].

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