PMID- 28017846
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1542-7714 (Electronic)
IS  - 1542-3565 (Linking)
VI  - 15
IP  - 6
DP  - 2017 Jun
TI  - Increased Post-procedural Non-gastrointestinal Adverse Events After Outpatient 
      Colonoscopy in High-risk Patients.
PG  - 883-891.e9
LID - S1542-3565(16)31239-3 [pii]
LID - 10.1016/j.cgh.2016.12.015 [doi]
AB  - BACKGROUND & AIMS: The incidence and predictors of non-gastrointestinal (GI) 
      adverse events (AEs) after colonoscopy are not well-understood. We studied the 
      effects of antithrombotic agents, cardiopulmonary comorbidities, and age on risk 
      of non-GI AEs after colonoscopy. METHODS: We performed a retrospective 
      longitudinal analysis to assess the diagnosis, procedure, and prescription drug 
      codes in a United States commercial claims database (March 2010-March 2012). Data 
      from patients at increased risk (n = 82,025; defined as patients with pulmonary 
      comorbidities or cardiovascular disease requiring antithrombotic medications) 
      were compared with data from 398,663 average-risk patients. In a 1:1 matched 
      analysis, 51,932 patients at increased risk, examined by colonoscopy, were 
      compared with 51,932 matched (on the basis of age, sex, and comorbidities) 
      patients at increased risk who did not undergo colonoscopy. We tracked cardiac, 
      pulmonary, and neurovascular events 1-30 days after colonoscopy. RESULTS: Thirty 
      days after outpatient colonoscopy, non-GI AEs were significantly higher in 
      patients taking antithrombotic medications (7.3%; odds ratio [OR], 10.75; 95% 
      confidence interval, 10.13-11.42) or those with pulmonary comorbidities (1.8%; 
      OR, 2.44; 95% confidence interval, 2.27-2.62) vs average-risk patients (0.7%) and 
      in patients 60-69 years old (OR, 2.21; 95% confidence interval, 2.01-2.42) or 70 
      years or older (OR, 6.45; 95% confidence interval, 5.89-7.06), compared with 
      patients younger than 50 years. The 30-day incidence of non-GI AEs in patients at 
      increased risk who underwent colonoscopy was also significantly higher than in 
      matched patients at increased risk who did not undergo colonoscopy in the 
      anticoagulant group (OR, 2.31; 95% confidence interval, 2.01-2.65) and in the 
      chronic obstructive pulmonary disease group (OR, 1.33; 95% confidence interval, 
      1.13-1.56). CONCLUSIONS: Increased number of comorbidities and older age (older 
      than 60 years) are associated with increased risk of non-GI AEs after 
      colonoscopy. These findings indicate the importance of determining comorbid risk 
      and evaluating antithrombotic management before colonoscopy.
CI  - Copyright (c) 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.
FAU - Johnson, David A
AU  - Johnson DA
AD  - Department of Gastroenterology, Eastern Virginia Medical School, Norfolk, 
      Virginia. Electronic address: Dajevms@aol.com.
FAU - Lieberman, David
AU  - Lieberman D
AD  - Division of Gastroenterology and Hepatology, Oregon Health and Science 
      University, Portland, Oregon.
FAU - Inadomi, John M
AU  - Inadomi JM
AD  - Division of Gastroenterology, University of Washington School of Medicine, 
      Seattle, Washington.
FAU - Ladabaum, Uri
AU  - Ladabaum U
AD  - Gastrointestinal Cancer Prevention Program, Division of Gastroenterology and 
      Hepatology, Stanford University Medical Center, Stanford, California.
FAU - Becker, Richard C
AU  - Becker RC
AD  - Division of Cardiovascular Health and Diseases, University of Cincinnati College 
      of Medicine, Cincinnati, Ohio.
FAU - Gross, Seth A
AU  - Gross SA
AD  - Division of Gastroenterology, NYU Langone Medical Center, New York, New York.
FAU - Hood, Kristin L
AU  - Hood KL
AD  - Medtronic, Mansfield, Massachusetts.
FAU - Kushins, Susan
AU  - Kushins S
AD  - Medtronic, Mansfield, Massachusetts.
FAU - Pochapin, Mark
AU  - Pochapin M
AD  - Division of Gastroenterology, NYU Langone Medical Center, New York, New York.
FAU - Robertson, Douglas J
AU  - Robertson DJ
AD  - Department of Gastroenterology, VA Medical Center, White River Junction, Vermont 
      and Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
LA  - eng
PT  - Journal Article
DEP - 20161223
PL  - United States
TA  - Clin Gastroenterol Hepatol
JT  - Clinical gastroenterology and hepatology : the official clinical practice journal 
      of the American Gastroenterological Association
JID - 101160775
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Colonoscopy/*adverse effects
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - *Outpatients
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - United States
MH  - Young Adult
OTO - NOTNLM
OT  - Adverse Events
OT  - Antithrombotic
OT  - Cardiovascular Disease
OT  - Colonoscopy
EDAT- 2016/12/27 06:00
MHDA- 2018/02/13 06:00
CRDT- 2016/12/27 06:00
PHST- 2016/10/06 00:00 [received]
PHST- 2016/12/12 00:00 [revised]
PHST- 2016/12/12 00:00 [accepted]
PHST- 2016/12/27 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
PHST- 2016/12/27 06:00 [entrez]
AID - S1542-3565(16)31239-3 [pii]
AID - 10.1016/j.cgh.2016.12.015 [doi]
PST - ppublish
SO  - Clin Gastroenterol Hepatol. 2017 Jun;15(6):883-891.e9. doi: 
      10.1016/j.cgh.2016.12.015. Epub 2016 Dec 23.