Colonoscopy-associated perforation: systematic review and meta-analysis of incidence and risk factors

Colonoscopy-associated perforation: systematic review and meta-analysis of incidence and risk factors

Collection:
Health Policy and Services Research
Series Title(s):
Pennsylvania patient safety advisory
Contributor(s):
Noble, Meredith
Clarke, John R.
Schoen, Robert E.
Reynolds, James C.
Schoelles, Karen.
Pennsylvania. Patient Safety Authority.
ECRI (Organization)
Institute for Safe Medication Practices.
Publication:
[Harrisburg, Pa.] : Pennsylvania Patient Safety Authority, c2012
Language(s):
English
Format:
Text
Subject(s):
Colonic Neoplasms -- diagnosis
Colonoscopy -- adverse effects
Incidence
Intestinal Perforation -- epidemiology
Intestinal Perforation -- etiology
Risk Factors
United States
Genre(s):
Meta-Analysis
Technical Report
Abstract:
Colonoscopy is an important tool for colorectal cancer screening and diagnosis, but reports of the incidence of perforation, a serious complication, vary widely, and risk factors have not been clearly identified. Using meta-analysis and a qualitative literature review, the authors systematically assessed the incidence of and risk factors for colonoscopy-associated perforation. Data on 966,172 screening and diagnostic colonoscopies from 38 original studies was combined in random-effects meta-analysis. The overall perforation incidence was 91 (95% CI: 77 to 104) per 100,000 colonoscopies. Screening colonoscopy had a lower incidence rate (41 [95% CI: 8 to 75] per 100,000 colonoscopies) than diagnostic colonoscopy and studies with mixed indications for colonoscopy (102 [95% CI: 86 to 118] per 100,000 colonoscopies). No other risk factor was identified by this meta-analysis. Published evidence suggests advanced age, polypectomy/biopsy, previous abdominal surgery, gastrointestinal comorbidities, and hemodialysis may be associated with increased risk. Despite the widespread use of colonoscopy and the seriousness of bowel perforation, information on risk factors, especially modifiable risk factors, is limited.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
Extent:
1 online resource (1 PDF file (pages 5-10))
Illustrations:
Illustrations
NLM Unique ID:
101579306 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101579306