Increased Anesthesia Usage in a Large-Volume Endoscopy Unit: Patient Acuity Is Not the Main Predictor.

Area of Science:

• Gastroenterology
• Anesthesiology
• Health Services Research

Background:

• Monitored anesthesia care (MAC) use for colonoscopy sedation is rising.
• Understanding trends and influencing factors is crucial for resource allocation and patient care.

Purpose of the Study:

• To examine the 9-year trend in MAC utilization for colonoscopies.
• To identify patient-specific variables associated with MAC use during this period.

Main Methods:

• Retrospective review of 37,803 colonoscopies performed between 2003 and 2012.
• Analysis of MAC usage versus sedative doses and patient variables (e.g., ASA class, comorbidities).
• Statistical analysis including t-tests, chi-squared tests, and logistic regression.

Main Results:

• MAC use for colonoscopies surged from 0.38% in 2003 to 10.0% in 2012 (P < 0.0001).
• Patient factors like female sex, higher ASA class, and certain diseases were associated with MAC use.
• The year of the procedure was the strongest predictor, with adjusted odds of MAC use increasing 1.5-fold annually.

Conclusions:

• Significant increase in MAC utilization for colonoscopies observed from 2003 to 2012.
• While patient characteristics correlated with MAC use, procedural year was the dominant factor.
• Non-patient-related factors likely influenced the rising trend of MAC for colonoscopies.