Onset and clinical course of bleeding and perforation after outpatient colonoscopy: a population-based study

Abstract

Background: Endoscopists are advised to measure and report their rates of colonoscopy-associated perforation and bleeding. However, evidence from population-based studies is lacking on the time period over which monitoring is needed to detect these adverse events.

Objective: To determine the time course of perforation or bleeding requiring hospital admission within 30 days after outpatient colonoscopy.

Design: Population-based cohort study.

Setting: Ontario, Canada.

Patients and interventions: Men and women, 50 to 75 years old who underwent an outpatient colonoscopy during the period from April 1, 2002 to March 31, 2003.

Main outcome measurements: Hospitalization for colonoscopy-related perforation or bleeding within 30 days after the procedure.

Results: We identified 67,632 patients who had an outpatient colonoscopy, of whom 37 were admitted for hospitalization with perforation and 83 with bleeding within 30 days after the procedure. For those with a perforation, 34 of 37 (92%) were admitted within 2 days and all within 5 days. For those with bleeding, 30 of 83 (36%) were admitted within 2 days and 80 of 83 (96%) within 14 days.

Limitations: Lack of information on medication use.

Conclusions: After outpatient colonoscopy, use of a 14-day time period for reporting would capture all perforations and the majority (96%) of bleeds requiring hospital admission.