Adverse Event Fatalities Related to GI Endoscopy

Area of Science:

• Gastroenterology
• Medical Safety
• Epidemiology

Background:

• Deaths following endoscopic procedures are infrequent but can have diverse causes.
• Under-reporting of fatal endoscopic adverse events (AEs) is a concern.
• Identifying risk factors for fatal AEs is crucial for improving patient safety.

Purpose of the Study:

• To determine the incidence and causes of fatal endoscopic AEs.
• To identify patient, procedure, and sedation-related risk factors for these events.
• To analyze data from two major academic medical centers.

Main Methods:

• Retrospective cohort study of fatal AEs causally linked to endoscopy.
• Data collected from Denver Health Medical Center and University of Colorado Hospital (2011-2020).
• Involved reviewing physician-reported databases and electronic medical records.

Main Results:

• A total of 146,010 GI endoscopy procedures were performed.
• 28 deaths (0.018% fatality rate) were attributed to endoscopy.
• Leading causes of death included perforation (32%), cardiac events (25%), and aspiration (14%).

Conclusions:

• Fatal endoscopic AEs are rare, predominantly affecting older patients with significant comorbidities.
• Deaths commonly resulted from aspiration pneumonia, cardiac arrest, or perforation-induced sepsis within one week post-procedure.