Process quality and incidence of acute complications in a series of more than 230 000 outpatient colonoscopies

Crispin, Alexander; Birkner, Bernhard; Munte, Axel; Nusko, G.; Mansmann, Ulrich

doi:10.1055/s-0029-1215214

Cited by 120 publications

(106 citation statements)

References 12 publications

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“…We first excluded all subjects who had a history of CP/CPPS since the beginning of the NHI program in 1995. Thereafter, we selected 3933 controls matched with cases by age group (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)30-39, 40-49, 50-59, 60-69, and >69 years) and index year. We selected the controls by matching them to a given CP/CPPS case simply due to use of medical services in the same index year of that particular case.…”

Section: Selection Of Cases and Controlsmentioning

confidence: 99%

Chronic prostatitis/chronic pelvic pain syndrome is associated with previous colonoscopy

Tsai

Lin

Lee

et al. 2017

CUAJ

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Introduction: This study aimed to examine the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and receipt of a prior colonoscopic examination using a populationbased database. Methods: We used the Taiwan Longitudinal Health Insurance Database 2005 to retrieve the study sample. This study included 3933 patients with CP/CPPS and 3933 age-matched controls. We designated the date of receiving the first diagnosis of CP/CPPS as the index date for cases. We defined the first an ambulatory care visit occurring in the matched year as the index date for the controls. Conditional logistic regressions was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for having previously received colonoscopy between cases and controls. Results: We found that 349 (4.44%) of the 7866 sampled patients had previously undergone colonoscopy, including 223 (5.67%) cases and 126 (3.20%) controls (p<0.001). A conditional logistic regression analysis revealed that the adjusted OR of receiving a colonoscopy within three years before the index date was 1.77 (95% CI 1.42-2.23) for cases compared to controls. Furthermore, we found that the youngest group of cases (<40 years) had the greatest adjusted OR for having received colonoscopy within three years before the index date compared to controls (OR 2.81; 95% CI 1.45-5.44); however, in contrast, no significant difference in the adjusted odds of having previously received colonoscopy was observed between cases and controls among the oldest age group (≥60 years). Conclusions: We concluded that there was an association between antecedent colonoscopy and CP/CPPS.

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Section: Selection Of Cases and Controlsmentioning

confidence: 99%

Chronic prostatitis/chronic pelvic pain syndrome is associated with previous colonoscopy

Tsai

Lin

Lee

et al. 2017

CUAJ

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“…Ongoing audit is necessary to determine whether this problem is persistent and whether a quality improvement programme is necessary to address this. [1][2][3]10,12] The ongoing drive to ensure that training is quantified and standardised across national centres has involved the mandatory keeping of procedural logbooks. However, these logbooks have mostly been manual, and concerns have been raised that they are not standardised.…”

Section: Quality Of Bowel Preparation the Asgementioning

confidence: 99%

An electronic colonoscopy record system enables detailed quality assessment and benchmarking of an endoscopic service

2015

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Background. Competence in colonoscopy, which is a technically difficult procedure, requires adequate exposure to it and the maintenance of a detailed logbook. Without an electronic record this is difficult to achieve. By implementing an electronic medical record system we aimed to perform a detailed quality assessment audit of colonoscopy, to benchmark our results and generate accurate logbooks for individual endoscopists. Methods. We reviewed the prospectively maintained Hybrid Electronic Medical Registry (HEMR). Colonoscopies performed betweenMarch 2013 and March 2014 were reviewed, and for competency, quality metrics were derived from the guidelines of the American Society of Gastroenterology. Results. A total of 843 colonoscopies were performed. Seven hundred and seventy procedures were performed by three staff endoscopists who each performed over the required 150 procedures annually (n=197, 338 and 235). The remaining 73 (8.7%) were performed by other staff. In 105 cases (12.5%), bowel preparation was deemed to be inadequate, which caused the procedure to be abandoned in 34 cases. A total of 64 cases were deemed to be incomplete because of obstructing lesions (n=26), extensive diverticulosis (n=4), technical difficulty (n=31) and patient discomfort (n=3). There were two complications recorded: perforation (n=1) and bleeding (n=1). Conclusions. The HEMR system enabled the audit of experiences with colonoscopy in our institution. Our results are broadly compatible with the international literature and with a number of guidelines. The development of an electronic record system is a major advance, as it enables meaningful benchmarking and the generation of accurate procedural logbooks.

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“…The importance of colonoscopy in colorectal cancer screening and surveillance is established [7,8]. However it is not innocuous [9,10]. It can be a source of morbidity and/or death-and it is binding for the patient (pain and bowel preparation).…”

Section: Introductionmentioning

confidence: 99%

Appropriateness of colonoscopy in Cocody teaching hospital center in 2010: A prospective study using criteria established by the European panel on the appropriateness of gastrointestinal endoscopy (EPAGE)

Assi¹,

Lohouès-Kouacou²,

Allah-Kouadio³

et al. 2012

OJGas

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Aims: 1) To assess the feasibility of EPAGE criteria in clinical practice; 2) To assess appropriateness colonoscopy using EPAGE criteria; 3) To compare colonoscopy appropriateness and endoscopic lesions. Method: Hundred thirty-nine consecutive patients explored by colonoscopy were included. The appropriateness of colonoscopy was evaluated by EPAGE criteria. Results: EPAGE criteria were applicable among 127 patients (91% of the cases). Colonoscopies were appropriate, uncertain and inappropriate in respectively 40%; 27% and 24% of the cases. Rate of abnormal colonoscopies was significantly different between the 3 groups (p = 0.03). Cancers were diagnosed exclusively in the groups with appropriate and uncertain colonoscopies (11% and 5%). Colonic adenomas were observed in the three groups (appropriate (7%), uncertain (5%) and inappropriate (6%)). Subjects with uncertain indication were older (58.25 years; p = 0.035). Conclusion: EPAGE criteria are feasible in clinical practice in Cocody's teaching hospital center. Colonoscopies are generally appropriate in our hospital. However, within sight of the significant number of normal colonoscopies and discovered lesions in uncertain indication, colonoscopy cannot concern exclusively calculation of a score of appropriateness.

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Process quality and incidence of acute complications in a series of more than 230 000 outpatient colonoscopies

Abstract: Outpatient colonoscopy is a safe procedure with a low risk of acute complications. Improving bowel preparation enhances completeness. Sedation/analgesia is conducive to both completeness and the lowering of the risk of acute complications.

Cited by 120 publications

References 12 publications

Chronic prostatitis/chronic pelvic pain syndrome is associated with previous colonoscopy

Chronic prostatitis/chronic pelvic pain syndrome is associated with previous colonoscopy

An electronic colonoscopy record system enables detailed quality assessment and benchmarking of an endoscopic service

Appropriateness of colonoscopy in Cocody teaching hospital center in 2010: A prospective study using criteria established by the European panel on the appropriateness of gastrointestinal endoscopy (EPAGE)

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