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Colonoscopy complications more likely in patients with IBD

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ORLANDO, Fla. — Patients with inflammatory bowel disease were significantly more likely to have complications after colonoscopy than patients without IBD, according to a poster presentation at Advances in IBD 2017.

These findings led investigators to recommend using noninvasive strategies as an alternative to colonoscopy in high-risk patients.

In light of the increasing support for using colonoscopy to evaluate mucosal healing in patients with IBD, investigators from Johns Hopkins University aimed to assess the colonoscopy complication rate in this patient population, including perforations, infections and sepsis. To do so, they evaluated claims data from ASCs, inpatient emergency visit claims across six geographically and racially diverse U.S. states from 2014, and compared colonoscopy complication rates between 35,707 patients with IBD and 1,340,501 patients without IBD.

They found that 14.6 of every 1,000 patients without IBD who underwent colonoscopy experienced a complication within 1 week vs. 19.2 patients with ulcerative colitis (RR = 1.31; 95% CI, 1.19-1.45) and 22.7 patients with Crohn’s disease (RR = 1.55; 95% CI, 1.4-1.72). The 30-day complication rates were 38.2 per 1,000 patients with IBD vs. 44.9 for UC (RR = 1.17; 95% CI, 1.1-1.25) and 55.1 for CD (RR = 1.44; 95% CI, 1.35-1.54).

Of note, Clostridium difficile infection after colonoscopy was seven times more common in patients with CD and 13 times more common in patients with UC, even after excluding patients with pre-existing conditions.

Finally, the researchers identified predictors of complications among patients with IBD, the strongest of which were recent history of hospitalization (adjusted OR = 4.13; 95% CI, 2.75-6.19 for CD; aOR = 5.72; 95% CI, 3.72-8.81 for UC) and endoscopic procedures (aOR = 1.72; 95% CI, 0.83-3.55 for CD; aOR = 3.34; 95% CI, 1.87-5.95 for UC). – by Adam Leitenberger

Reference:

Wang P, et al. Abstract P-016. Presented at: Advances in IBD; Nov. 9-11, 2017; Orlando, Fla.

Disclosures: Healio Gastroenterology and Liver Disease was unable to confirm the study authors’ relevant financial disclosures at the time of publication.