0
Summaries for Patients |

Adverse Events After Colonoscopy in the Medicare Population FREE

[+] Article and Author Information

The summary below is from the full report titled “Adverse Events After Outpatient Colonoscopy in the Medicare Population.” It is in the 16 June 2009 issue of Annals of Internal Medicine (volume 150, pages 849-857). The authors are J.L. Warren, C.N. Klabunde, A.B. Mariotto, A. Meekins, M. Topor, M.L. Brown, and D.F. Ransohoff.


Ann Intern Med. 2009;150(12):I-32. doi:10.7326/0003-4819-150-12-200906160-00004
Text Size: A A A

What is the problem and what is known about it so far?

Colonoscopy is a method for inspecting the surface of the colon (also called the large bowel). Although colonoscopy has many uses, the most common use is to screen for colon cancer, to investigate symptoms of colon cancer (such as blood in the stool), to prevent colon cancer (by removing polyps), and to check for recurrence after removing polyps or after surgery for colon cancer. Colonoscopy is a safe test, but things occasionally go wrong. The most common problem is bleeding after biopsy of a polyp or cancer. A more rare but more serious problem is when a hole is punched in the wall of the colon (a perforation); the complication occurs about 3 times in every 1000 colonoscopies.

Why did the researchers do this particular study?

The rate of serious complications of colonoscopy in older persons is not known. In addition, the rate of similar complications in persons who did not have colonoscopy is not known.

Who was studied?

The authors studied a large, randomly selected sample of Medicare patients (older than 65 years). Some had colonoscopy. The control participants, who did not have colonoscopy, were the same age and sex as patients who did have colonoscopy.

How was the study done?

The authors measured the rates of serious complications by checking to see whether the patients had been admitted to the hospital or gone to the emergency department within 30 days of colonoscopy because of a heart problem or a gastrointestinal problem (including perforation or bleeding). The authors also checked to see whether the control patients had a similar problem during the same time. These diagnoses are recorded when hospitals submit a claim to Medicare for payment after seeing a Medicare patient.

What did the researchers find?

The rate of gastrointestinal problems was higher in patients receiving colonoscopies than in control participants. For example, the rate of bleeding or perforation was 6.9 per 1000 patients receiving colonoscopies but only 1.8 per 1000 control participants. Rates were higher if the doctor performed a biopsy. Patients who were older or had many chronic conditions (such as high blood pressure or diabetes) had higher rates.

What were the limitations of the study?

The only source of information about complications was claims for payment, which do not have the information to be certain about whether the patient's problem was really due to the colonoscopy.

What are the implications of the study?

Doctors and patients should think about the risks when deciding whether to do a colonoscopy, especially if the patient is old or sick to determine whether the information that the colonoscopy might give is worth the risk for complications.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)