The Impact of Hospital Teaching Status on Colonoscopy Perforation Risk: A National Inpatient Sample Study.
Colonoscopy
Hospital teaching status
Perforation
Journal
Gastroenterology research
ISSN: 1918-2805
Titre abrégé: Gastroenterology Res
Pays: Canada
ID NLM: 101519422
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
01
11
2019
accepted:
06
12
2019
entrez:
26
2
2020
pubmed:
26
2
2020
medline:
26
2
2020
Statut:
ppublish
Résumé
Colonoscopy has been widely used as a diagnostic tool for many conditions, including inflammatory bowel disease and colorectal cancer. Colonoscopy complications include perforation, hemorrhage, abdominal pain, as well as anesthesia risk. Although rare, perforation is the most dangerous complication that occurs in the immediate post-colonoscopy period with an estimated risk of less than 0.1%. Studies on colonoscopy perforation risk between teaching hospitals and non-teaching hospitals are scarce. The National Inpatient Sample database was queried for patients who underwent inpatient colonoscopy between January 2010 and December 2014 in teaching versus non-teaching facilities in order to study their perforation rates. Our study population included 257,006 patients. Univariate regression was performed, and the positive results were analyzed using a multivariate regression module. Teaching hospitals had a higher risk of perforation (odds ratio 1.23, confidence interval 1.07 - 1.42, P = 0.004). Perforation rates were higher in females, patients with inflammatory bowel disease and dilatation of strictures. Polypectomy did not yield any statistical difference between the study groups. Other factors such as African-American ethnicity appeared to have a lower risk. Perforation rates are higher in teaching hospitals. More studies are needed to examine the difference and how to mitigate the risks.
Sections du résumé
BACKGROUND
BACKGROUND
Colonoscopy has been widely used as a diagnostic tool for many conditions, including inflammatory bowel disease and colorectal cancer. Colonoscopy complications include perforation, hemorrhage, abdominal pain, as well as anesthesia risk. Although rare, perforation is the most dangerous complication that occurs in the immediate post-colonoscopy period with an estimated risk of less than 0.1%. Studies on colonoscopy perforation risk between teaching hospitals and non-teaching hospitals are scarce.
METHODS
METHODS
The National Inpatient Sample database was queried for patients who underwent inpatient colonoscopy between January 2010 and December 2014 in teaching versus non-teaching facilities in order to study their perforation rates. Our study population included 257,006 patients. Univariate regression was performed, and the positive results were analyzed using a multivariate regression module.
RESULTS
RESULTS
Teaching hospitals had a higher risk of perforation (odds ratio 1.23, confidence interval 1.07 - 1.42, P = 0.004). Perforation rates were higher in females, patients with inflammatory bowel disease and dilatation of strictures. Polypectomy did not yield any statistical difference between the study groups. Other factors such as African-American ethnicity appeared to have a lower risk.
CONCLUSION
CONCLUSIONS
Perforation rates are higher in teaching hospitals. More studies are needed to examine the difference and how to mitigate the risks.
Identifiants
pubmed: 32095169
doi: 10.14740/gr1234
pmc: PMC7011915
doi:
Types de publication
Journal Article
Langues
eng
Pagination
19-24Informations de copyright
Copyright 2020, Khalid et al.
Déclaration de conflit d'intérêts
All the authors have no conflict of interest to disclose.
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