Original articleClinical endoscopyAdverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis
Section snippets
Study population
We performed a systematic review of computerized bibliography databases for elderly patients who underwent colonoscopy. We defined elderly using the World Health Organization's definition of a patient 65 years of age and older. Studies were included if data pertaining to patients 65 years of age and older and documented adverse events related to colonoscopy were reported and could be abstracted. Colonoscopies may have been performed in either the outpatient or inpatient setting and could have
Results
Our initial search strategy yielded 3328 articles. After initial title and abstract review, 88 articles remained for full manuscript review. Sixty-eight articles were excluded with the most frequent reason being that both the number of colonoscopies and specific number of adverse events could not be abstracted from the articles and stratified into either 65 years of age and older or 80 years of age and older age groups (Fig. 1). Twenty articles remained for inclusion in the study with 3 studies
Discussion
As individuals live longer, information regarding the differences in the risk of colonoscopy by age becomes increasingly important for patients and providers. In the articles retrieved for our study, the elderly overwhelmingly underwent colonoscopy for diagnostic purposes. Among individuals 65 years of age and older, the cumulative GI adverse event rate (perforation, bleeding, and CV/pulmonary) was 26.0/1000 colonoscopies, whereas in octogenarian patients, the cumulative adverse event rate
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DISCLOSURE: The authors disclosed no financial relationships relevant to this publication. This work was funded in part by grants from the Mount Zion Health Fund and American Society for Gastrointestinal Endoscopy Cook Career Development Award (M.S.) and from the National Institute of Diabetes and Digestive and Kidney Diseases (K24 DK080941) (J.M.I.). Dr. Walter is supported by a VA Health Services Research and Development grant IIR-04-427 and by grant 1R01CA134425 from the National Cancer Institute.
If you would like to chat with an author of this article, you may contact Dr. Day at [email protected].