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DOI: 10.1055/s-0039-1681601
POST-COLONOSCOPY COMPLICATIONS WITHIN THE COLORECTAL CANCER SCREENING PROGRAMS OF THE VENETO REGION (ITALY)
Publication History
Publication Date:
18 March 2019 (online)
Aims:
To define the complication rate and the 30-days mortality rate after colonoscopy within the colorectal cancer screening programs of the Veneto Region (North East of Italy) and to identify the variables associated with complications.
Methods:
We considered the subjects who underwent a colonoscopy after a positive fecal immunochemical test (FIT+) from 2002 to 2014. Complications and deaths occurring within 30 days after colonoscopy were identified using the regional Hospital Discharge Records dataset. Complications were classified as follows: perforation (suspected/confirmed), hemorrhage, post-polipectomy syndrome, not otherwise specified complicated polipectomy, cardiovascular, other.
We computed complication and mortality rates and evaluated the variables associated with complications through multivariate analysis.
Results:
We included in the study 117,881 subjects, who underwent a colonoscopy within the regional screening program. Overall, 497 complications were recorded (complication rate 0.42%), which included 281 hemorrhages (57%), 65 perforations (13%), 27 post-polipectomy syndromes (5.4%), 59 complicated polipectomy NOS (12%) and 49 cardiovascular complications (9.9%).
Seventeen subjects died within 30 days after colonoscopy, possibly due to causes related to the exam (mortality rate 1.44 × 10,000).
The risk of complications was significantly higher in case of completion colonoscopies (Odds Ratio vs. first post-FIT+ colonoscopy 1.64; p = 0.026), age (OR per 5-year increase 1.12; p = 0.005), incomplete colonoscopy (OR 2.44; p < 0.001), operative procedure (OR 1.74; p = 0.001), diagnosis of carcinoma (OR vs. negative 9.73; p < 0.001), high risk adenoma (OR 7.60; p < 0.001) and low risk adenoma (OR 2.33; p = 0.001).
Conclusions:
The complication and mortality rate of screening programs of the Veneto Region are comparable with the data from the literature. Hospital Discharge Records are a useful source of data for identifying post-colonoscopy complications.