PMID- 33860417
OWN - NLM
STAT- MEDLINE
DCOM- 20220531
LR  - 20220609
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 67
IP  - 5
DP  - 2022 May
TI  - Adverse Event Fatalities Related to GI Endoscopy.
PG  - 1753-1760
LID - 10.1007/s10620-021-06981-9 [doi]
AB  - BACKGROUND: Death after endoscopy is rare, under-reported, and has variable 
      causes. This study aimed to evaluate the incidence and causes of fatal endoscopic 
      adverse events (AEs) across two academic medical centers and to identify 
      patient-, procedure-, and sedation-related risk factors. METHODS: This is a 
      retrospective cohort study of fatal adverse events causally related to endoscopy 
      at Denver Health Medical Center and the University of Colorado Hospital from 2011 
      to 2020. Fatal AEs were retrieved from the physician-reported database. 
      Electronic medical records were then reviewed to determine medical history, 
      procedure details, subsequent treatments, and time and cause of death. RESULTS: 
      From January 2011 to January 2020, 146,010 GI endoscopy procedures were 
      performed. Median patient age was 70 [51-78] and 57% were male. Thirty-one deaths 
      were identified, 28 of which were attributed to endoscopy, yielding a 
      procedure-related fatality rate of 0.018%. Procedures included 11 EGDs, one 
      colonoscopy, two flexible sigmoidoscopies, six ERCPs, seven upper EUS, and one 
      PEG-J tube placement. Specific causes of death included aspiration in four 
      patients (14%); cardiac arrest or myocardial infarction in seven patients (25%); 
      perforation in nine patients (32%); bleeding in four patients (14%); cholangitis 
      or sepsis without perforation in three patients (11%); and acute pancreatitis in 
      one patient (3.6%). CONCLUSIONS: Fatal endoscopic AEs were rare but tended to 
      occur in older patients with major comorbidities. Most deaths occurred from 
      aspiration pneumonia, cardiac arrest, or perforation-related sepsis within 1 week 
      of the procedure.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Swei, Eric
AU  - Swei E
AD  - Division of Gastroenterology and Hepatology, Denver Health Medical Center, 601 
      Broadway, MC 4000, Denver, CO, 80203, USA.
FAU - Heller, J Christie
AU  - Heller JC
AD  - Division of Gastroenterology and Hepatology, Denver Health Medical Center, 601 
      Broadway, MC 4000, Denver, CO, 80203, USA.
FAU - Scott, Frank
AU  - Scott F
AD  - Division of Gastroenterology and Hepatology, Denver Health Medical Center, 601 
      Broadway, MC 4000, Denver, CO, 80203, USA.
FAU - Attwell, Augustin
AU  - Attwell A
AUID- ORCID: 0000-0001-7122-8684
AD  - Division of Gastroenterology and Hepatology, Denver Health Medical Center, 601 
      Broadway, MC 4000, Denver, CO, 80203, USA. augustin.attwell@dhha.org.
LA  - eng
PT  - Journal Article
DEP - 20210415
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Endoscopy, Gastrointestinal/adverse effects
MH  - Female
MH  - *Heart Arrest/etiology
MH  - Humans
MH  - Male
MH  - *Pancreatitis/etiology
MH  - Retrospective Studies
MH  - *Sepsis/etiology
OTO - NOTNLM
OT  - Adverse events
OT  - Endoscopy
OT  - Mortality
OT  - Quality improvement
EDAT- 2021/04/17 06:00
MHDA- 2022/06/01 06:00
CRDT- 2021/04/16 06:47
PHST- 2020/10/29 00:00 [received]
PHST- 2021/03/30 00:00 [accepted]
PHST- 2021/04/17 06:00 [pubmed]
PHST- 2022/06/01 06:00 [medline]
PHST- 2021/04/16 06:47 [entrez]
AID - 10.1007/s10620-021-06981-9 [pii]
AID - 10.1007/s10620-021-06981-9 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2022 May;67(5):1753-1760. doi: 10.1007/s10620-021-06981-9. Epub 2021 
      Apr 15.