BackgroundScreening by means of biennial fecal occult blood test has provided a reduction in overall colorectal cancer mortality. Notwithstanding, we should not underestimate the harms that it can produce.AimThe aim of this article is to identify the independent risk factors of complications after a screening colonoscopy.MethodsA six-year, nested case-control study was conducted. Mortality/complications within 30 days after colonoscopy were registered and its predictors identified through logistic regression.ResultsAfter 39,254 colonoscopies, the complication rate was 1.0%. Independent predictors were sex (OR 1.68 for men; CI 95% 1.18–2.39), ASA physical status classification system (OR 1.73 for ASA II–III; CI 95% 1.53–3.69), history of abdominal surgery (OR 2.37; CI 95% 1.72–4.08), diverticulosis (OR 2.89; CI 95% 1.94–4.30), inadequate cleansing (OR 29.35; CI 95% 6.52–132.17), detection of advanced neoplasia (AN) (OR 4.92; CI 95% 3.29–7.36), detection of stage I adenocarcinoma (OR 9.44; CI 95% 4.46–20.0), polyps in right colon OR 2.27 CI 95% 1.38–3.74) and complex polypectomy (OR 2.00; CI 95% 1.25–3.20). The logistic model explained 82% of the complications (CI 95% 0.798–0.854, p < 0.001).ConclusionsColonoscopy, with or without removal of a lesion, is an invasive procedure with a non-deniable risk of major complications. Factors like inadequate cleansing or detection of AN are determinants. Therefore, it is vital to know which aspects predict their appearance to implement countermeasures.
United European Gastroenterology Journal – SAGE
Published: Jun 1, 2018
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