Physicians also should consider their patient's comorbidities before recommending procedure
TUESDAY, June 16 (HealthDay News) -- While the risk of adverse events from colonoscopy in elderly patients is low, it increases with age and comorbid conditions and should be a factor in a physician's decision to recommend the procedure, according to a study in the June 16 Annals of Internal Medicine.
Joan L. Warren, Ph.D., of the National Cancer Institute in Bethesda, Md., and colleagues studied a random sample of 5 percent of Medicare beneficiaries (age 66 to 95 years) who had colonoscopies as outpatients between July 2001 and October 2005, and compared the outcomes to matched beneficiaries who did not have colonoscopies. Medicare claims were used to determine the incidence and risk of adverse events, such as gastrointestinal perforation and cardiovascular events leading to hospitalization or emergency department visit. Logistic regression was used to assess adverse events risk by type of colonoscopy, age, and comorbidities.
The researchers found that the subjects who had colonoscopies, and especially those who had polypectomy, were at higher risk for gastrointestinal adverse events than their matched subjects, and the rate of adverse events increased with age. Comorbidities also increased adverse events risk, such as a history of congestive heart failure, atrial fibrillation, stroke, or chronic obstructive pulmonary disease.
"Risks for adverse events after outpatient colonoscopy among elderly Medicare beneficiaries were low; however, they increased with age, with specific comorbid conditions, and depending on whether polypectomy was done. These data may inform decisions on whether to perform colonoscopy in persons of advanced age or those with comorbid conditions," the authors write.