A national study of cardiopulmonary unplanned events after GI endoscopy

Sharma, Virender K.; Nguyen, Cuong C.; Crowell, Michael D.; Lieberman, David A.; Garmo, Pat de; Fleischer, David E.

doi:10.1016/j.gie.2006.12.040

Cited by 393 publications

(331 citation statements)

References 16 publications

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Section: Discussionmentioning

confidence: 99%

“…[19][20][21] Risk factors for cardiopulmonary complications in adults include intravenous sedation, obesity, advanced age, and chronic lung disease. 22 In general, children require more sedation medication than adults; therefore, hypoxic events and adverse effects of sedative medicines might be more likely.…”

Section: Discussionmentioning

confidence: 99%

“…7 For example, a recent CORI report of cardiopulmonary complications in 174,255 colonoscopy procedures revealed a 1.1% (95% CI, 1.0-1.2) immediate complication rate. 21 Because our data were generally entered shortly after completion, the reported complication rate might be an underestimate.In conclusion, complications of colonoscopy in children occur in approximately 1% of procedures. This study suggests that the immediate complication rate of colonoscopy in children is comparable to the adult population.…”

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confidence: 99%

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Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Thakkar

El–Serag

Mattek

et al. 2008

Clinical Gastroenterology and Hepatology

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Colonoscopy has become a routine modality for the evaluation and treatment of colonic disorders in children. Although generally considered a safe procedure, colonoscopy has the potential for complications. Most informed consent forms describe adverse effects of sedative medicines, perforation, infection, and bleeding as possible risks of colonoscopy. However, the frequency of these complications remains unclear. There are limited pediatric data showing complication rates, and most prior studies involved small numbers of procedures. Furthermore, there might be additional complications that need to be added to consent protocols, because most current complication data are extrapolated from the much larger experience in adult populations.A review of pediatric literature demonstrated a wide array of potential complications and no large multicenter studies during the past 25 years. The largest study was conducted in [1978][1979] and included a survey of 1400 proctosigmoidoscopies performed during an 18-month period at 25 medical centers in the U.S. 1 This study was only published in abstract form and reported complications in 0.2% of all colonoscopy procedures. These complications included one hemorrhage requiring transfusion and one perforation. In the second largest study, Stringer et al 2 prospectively described a series of 250 flexible colonoscopies done in the United Kingdom during a 3.5-year period with no adverse events. Several other studies reported complications (Table 1) in pediatric colonoscopy, but the majority of these studies examined a small number of procedures.Determination of potential colonoscopy-related complications and their expected frequency in children can lead to enhanced risk-benefit analysis by physicians and patients and improved informed consent. There is a lack of systematic, multicenter studies in the pediatric population. Therefore, we conducted the current study to examine the frequency, type, and clinical determinants of immediate complications encountered during pediatric Address requests for reprints to: Kalpesh Thakkar, MD, 6621 Fannin St CCC 1010, Houston, TX 77030. kthakkar@bcm.tmc.edu; fax: 832-825-3633. Simple logistic regression was used to estimate the crude risk of cardiopulmonary events and gastrointestinal bleeding for variables that were identified as significantly associated with the outcomes during categorical analysis (P < .05). Multiple logistic regression models included all variables determined significant on univariate analysis. In constructing the models, we followed the commonly used heuristic of 10 outcome events for each explanatory variable. The adjusted risks estimate for each independent predictor variable was expressed as odds ratios. All analyses were performed by using SAS software (SAS Institute, Inc, Cary, NC). HHS Public Access ResultsDuring the study period, 8841 colonoscopies were recorded at 12 PEDS-CORI sites, and 1049 (11.9%) were excluded for incomplete procedure notes, duplicate records, or patient age older than 18 years. Thus, a total of 77...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Thakkar

El–Serag

Mattek

et al. 2008

Clinical Gastroenterology and Hepatology

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“…Questions relating to procedure assessment should be included on the board examination and should reflect a general knowledge of this content (70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83)(84)(85).…”

Section: Assessment Of Competencymentioning

confidence: 99%

Multisociety Sedation Curriculum for Gastrointestinal Endoscopy

Vargo¹,

DeLegge²,

Feld³

et al. 2012

Am J Gastroenterol

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“…Although cardiopulmonary and sedation-related events account for more than 50% of the severe morbidity and mortality related to gastrointestinal (GI) endoscopy [4], this document will focus only on major AEs related to endoscopic equipment direct harm, mainly haemorrhage, perforation, infection and embolization. Even though no sufficient consensus exists in most cases, we outlined the predisposing factors and putative prophylactic measures with comprehensive approaches to their management.…”

Section: Introductionmentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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A national study of cardiopulmonary unplanned events after GI endoscopy

Cited by 393 publications

References 16 publications

Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Complications of Pediatric Colonoscopy: A Five-Year Multicenter Experience

Multisociety Sedation Curriculum for Gastrointestinal Endoscopy

Emergencies after endoscopic procedures

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