Risk factors for severe complications of colonoscopy in screening programs
Por:
Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, Valverde MJ, Pérez E, Nolasco A, de la Vega M, de la Lastra-Bosch ID, Oceja M, Espinàs JA, Font R, Pérez-Riquelme F, Arana-Arri E, Portillo I, Salas D and CRIBEA Group
Publicada:
1 ene 2019
Ahead of Print:
8 nov 2018
Resumen:
Severe complications (SC) in colonoscopy represent the most important adverse effect of colorectal cancer screening programs (CRCSP). The objective is to evaluate the risk factors for SC in colonoscopy indicated after a positive fecal occult blood test in population-based CRCSP. The SC (n = 161) identified from 48,730 diagnostic colonoscopies performed in a cohort of all the women and men invited from 2000 to 2012 in 6 CRCSP in Spain. A total of 318 controls were selected, matched for age, sex and period when the colonoscopy was performed. Conditional logistic regression models were estimated. The analysis was performed separately in groups: immediate-SC (same day of the colonoscopy); late-SC (between 1 and 30 days after); perforation; and bleeding events. SC occurred in 3.30 parts per thousand of colonoscopies. Prior colon disease showed a higher risk of SC (OR = 4.87). Regular antiplatelet treatment conferred a higher risk of overall SC (OR = 2.80) and late-SC (OR = 9.26), as did regular anticoagulant therapy (OR = 3.47, OR = 7.36). A history of pelvic-surgery or abdominal-radiotherapy was a risk factor for overall SC (OR = 5.03), immediate-SC (OR = 8.49), late-SC (OR = 4.65) and perforation (OR = 21.59). A finding of adenoma or cancer also showed a higher risk of overall SC (OR = 8.71), immediate-SC (OR = 12.67), late-SC (OR = 4.08), perforation (OR = 4.69) and bleeding (OR = 17.02). The risk of SC doesn't vary depending on the type of preparation or type of anesthesia. Knowing the clinical history of patients such as regular previous medication and history of surgery or radiotherapy, as well as the severity of the findings during the colonoscopy process could help to focus prevention measures in order to minimize SC in CRCSP.
Filiaciones:
:
Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain
:
Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain
General Directorate Public Health, Valencian Community, Spain
:
Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain
:
General Directorate Public Health, Valencian Community, Spain
:
General Directorate Public Health, Valencian Community, Spain
:
University of Alicante, Spain
de la Vega M:
General Directorate of Assistance Programs, Canarias, Spain
de la Lastra-Bosch ID:
General Directorate of Assistance Programs, Canarias, Spain
Oceja M:
General Directorate Public Health, Cantabria, Spain
Espinàs JA:
Catalan Cancer Strategy, Department of Health, Catalonia, Spain
Biomedical Research Institute, Bellvitge, (IDIBELL) - L'Hospitalet de LLob, Barcelona, Spain
Font R:
Catalan Cancer Strategy, Department of Health, Catalonia, Spain
Biomedical Research Institute, Bellvitge, (IDIBELL) - L'Hospitalet de LLob, Barcelona, Spain
Pérez-Riquelme F:
General Directorate Public Health, Murcia, Spain
Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), University Clinical Hospital Virgen de la Arrixaca, University of Murcia, Spain
Arana-Arri E:
Biocruces Research Institute, Barakaldo, Spain
Portillo I:
The Basque Health Service, Basque Country, Spain
:
Cancer and Public Health Area, FISABIO - Public Health, Valencia, Spain
General Directorate Public Health, Valencian Community, Spain
|