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Patients with IBD at greater risk for post-endoscopy complications
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Complications and the need for medical care following an endoscopic procedure were more common among patients with IBD than controls in a recent study.
Researchers evaluated health care use within 14 days of outpatient colonoscopy, esophagogastroduodenoscopy or sigmoidoscopy among patients with IBD and controls treated at Beth Israel Deaconess Medical Center in Boston between March 1 and Nov. 30, 2007. The cohort included 685 procedures performed in 622 patients with IBD, and 17,330 procedures performed on controls. Complications, defined as endoscopy-related ED visits within 14 days of the procedure, were observed in both groups. Investigators also performed retrospective chart reviews of patients with IBD to assess health care use after procedures.
Complications were observed in 1.17% of patients and 0.96% of controls (P=.55). Within 2 weeks of endoscopy, 73 patients required health care use, 26 cases considered procedure related, for a post-procedure health care use rate of 3.8%. Fifty-four percent of these incidents were minor; the remainder required ED or hospital admission. Post-procedural complications requiring inpatient admission occurred in seven cases.
Using a Markov Monte Carlo model simulating routine screening and surveillance colonoscopy in 10,000 patients with IBD and 10,000 patients in the general population, the investigators calculated a 12.7% lifetime risk for complications, compared with 2% in the general population (P<.001), for a relative risk of 6.3 (95% CI, 5.4-7.3) among those with IBD. Likewise, patients had a higher mean number of complications per person (0.13 vs. 0.02; P<.001) and underwent more colonoscopies (13 vs. 3; P<.001).
“This study suggests that IBD and non-IBD cohorts have similar rates of endoscopy-related complications,” researcher Jason Ferreira, MD, division of gastroenterology at the medical center, told Healio.com. “However, our data propose that IBD patients will experience a six-fold significantly higher projected lifetime risk of post-endoscopic complications, given the increased volume of procedures this group endures.
“This amount of health care interaction following endoscopy represents a sizable burden to both the patient and physician, which was previously underappreciated.”
Disclosure: The researchers report no relevant financial disclosures.
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