PMID- 29423432
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220311
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 6
IP  - 2
DP  - 2018 Feb
TI  - Complications and outcomes of routine endoscopy in the very elderly.
PG  - E224-E229
LID - 10.1055/s-0043-120569 [doi]
AB  - BACKGROUND AND STUDY AIMS:  In Japan, the elderly population has been increasing 
      annually. The number of elderly patients for whom esophagogastroduodenoscopy 
      (EGD) and colonoscopy (CS) is indicated also has been rising. The aim of this 
      study was to evaluate the safety and efficacy of routine endoscopy in a cohort of 
      octogenarians aged 85 years and older - defined by the World Health Organization 
      as the very elderly. PATIENTS AND METHODS:  A total of 5,586 patients underwent 
      EGDs, and 2,484 patients underwent CSs performed at the Keio University Hospital 
      from January to September 2014. One hundred eighty-five EGDs and 70 of the CS 
      were performed in the very elderly. Six hundred nine EGDs and 262 CS were 
      performed on younger patients (aged forties). Statistical analysis was performed 
      by univariate and multivariate analyses. RESULTS:  On univariate analysis, the 
      rate of adverse events (AEs) in the very elderly was significantly higher 
      compared to the younger group (6.3 % vs. 1.1 %; P  < 0.01). Moreover, the very 
      elderly cohort received substantial therapeutic intervention as compared to the 
      younger (16.9 % vs. 6.9 %; P  < 0.01). On multivariate analysis, independent risk 
      factors of AEs included: very elderly patients (odds ratio (OR) 3.30, 95 % 
      confidence interval (CI) 1.05 - 10.35), inpatients (OR 3.22, 95 % CI 
      1.34 - 7.74), and use of pethidine hydrochloride prescription (OR 3.44, 95 % CI 
      1.51 - 7.81). CONCLUSIONS:  Routine endoscopy in the very elderly incurs a 
      significant risk of AEs, particularly when combined with pethidine hydrochloride 
      prescription.
FAU - Miyanaga, Ryoichi
AU  - Miyanaga R
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      School of Medicine, Keio University, Tokyo, Japan.
FAU - Hosoe, Naoki
AU  - Hosoe N
AD  - Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio 
      University, Tokyo, Japan.
FAU - Naganuma, Makoto
AU  - Naganuma M
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      School of Medicine, Keio University, Tokyo, Japan.
FAU - Hirata, Kenro
AU  - Hirata K
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      School of Medicine, Keio University, Tokyo, Japan.
FAU - Fukuhara, Seiichiro
AU  - Fukuhara S
AD  - Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio 
      University, Tokyo, Japan.
FAU - Nakazato, Yoshihiro
AU  - Nakazato Y
AD  - Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio 
      University, Tokyo, Japan.
FAU - Ojiro, Keisuke
AU  - Ojiro K
AD  - Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio 
      University, Tokyo, Japan.
FAU - Iwasaki, Eisuke
AU  - Iwasaki E
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      School of Medicine, Keio University, Tokyo, Japan.
FAU - Yahagi, Naohisa
AU  - Yahagi N
AD  - Division of Research and Development for Minimally Invasive Treatment, Cancer 
      Center, School of Medicine, Keio University, Tokyo, Japan.
FAU - Ogata, Haruhiko
AU  - Ogata H
AD  - Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio 
      University, Tokyo, Japan.
FAU - Kanai, Takanori
AU  - Kanai T
AD  - Division of Gastroenterology and Hepatology, Department of Internal Medicine, 
      School of Medicine, Keio University, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180207
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5802997
COIS- Competing interests None
EDAT- 2018/02/10 06:00
MHDA- 2018/02/10 06:01
PMCR- 2018/02/01
CRDT- 2018/02/10 06:00
PHST- 2016/10/22 00:00 [received]
PHST- 2017/07/17 00:00 [accepted]
PHST- 2018/02/10 06:00 [entrez]
PHST- 2018/02/10 06:00 [pubmed]
PHST- 2018/02/10 06:01 [medline]
PHST- 2018/02/01 00:00 [pmc-release]
AID - 10.1055/s-0043-120569 [doi]
PST - ppublish
SO  - Endosc Int Open. 2018 Feb;6(2):E224-E229. doi: 10.1055/s-0043-120569. Epub 2018 
      Feb 7.