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Onset and clinical course of bleeding and perforation after outpatient colonoscopy: a population-based study
Linda Rabeneck1, Refik Saskin, Lawrence F Paszat
1Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Background:
Endoscopists are advised to measure and report their rates of colonoscopy-associated perforation and bleeding. However, evidence from population-based studies is lacking on the time period over which monitoring is needed to detect these adverse events.
Objective:
To determine the time course of perforation or bleeding requiring hospital admission within 30 days after outpatient colonoscopy.
Design:
Population-based cohort study.
Setting:
Ontario, Canada.
Patients And Interventions:
Men and women, 50 to 75 years old who underwent an outpatient colonoscopy during the period from April 1, 2002 to March 31, 2003.
Main Outcome Measurements:
Hospitalization for colonoscopy-related perforation or bleeding within 30 days after the procedure.
Results:
We identified 67,632 patients who had an outpatient colonoscopy, of whom 37 were admitted for hospitalization with perforation and 83 with bleeding within 30 days after the procedure. For those with a perforation, 34 of 37 (92%) were admitted within 2 days and all within 5 days. For those with bleeding, 30 of 83 (36%) were admitted within 2 days and 80 of 83 (96%) within 14 days.
Limitations:
Lack of information on medication use.
Conclusions:
After outpatient colonoscopy, use of a 14-day time period for reporting would capture all perforations and the majority (96%) of bleeds requiring hospital admission.
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