Endoscopy 2020; 52(S 01): S258-S259
DOI: 10.1055/s-0040-1704809
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

COLONOSCOPY IN OLD AGE – INDICATIONS, OUTCOMES AND SAFETY

A Yusuf
1   East Sussex Healthcare NHS Trust, Gastroenterology, Eastbourne, United Kingdom
,
B Ayeboa-Sallah
2   East Sussex Healthcare NHS Trust, Medicine, Eastbourne, United Kingdom
,
A Jeevagan
1   East Sussex Healthcare NHS Trust, Gastroenterology, Eastbourne, United Kingdom
,
D Neal
1   East Sussex Healthcare NHS Trust, Gastroenterology, Eastbourne, United Kingdom
,
P Mayhead
1   East Sussex Healthcare NHS Trust, Gastroenterology, Eastbourne, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims The aim of this study was to review the indications, outcomes and safety of colonoscopy in the very elderly patients (≥ 85 years).

    Methods We retrospectively reviewed all patients ≥ 85 years who underwent colonoscopy from June 2016 to June 2018. We collected data on demographics, indications, bowel preparation, findings, caecal intubation and complication rates, 8-day readmission and 30-day mortality rates.

    Results There were 243 patients who underwent colonoscopy, mean age 87.0 years (range 85–96), males 41.8 %, females 51.9 %. The commonest indication: change in bowel habit (30.1%), anaemia (21.8%), abnormal imaging (12.3%), rectal bleeding (10.3%), polyp surveillance (7.4%), and bowel cancer surveillance (4.1%).

    Patients went thorough bowel preparation with PEG solution with excellent or adequate results in 209 (86.0%), and inadequate in 34 (14.0%). Unadjusted caecal intubation rate was 84.4 %, rising to 88.7 % when adjusted for obstructing lesions.

    Causes for incomplete procedure (n = 38): obstructing lesions (n = 12, 31.6%), inadequate bowel preparation (n = 7, 18.4%), patient intolerance (n = 6, 15.7 %), and diverticulosis (n = 5, 13.2%). Cancer was found in 21 patients (8.6%). Polyps of any size were found in 90 patients (37.0%), but significant polyps (polyps ≥ 10 mm) were found in 42 patients (17.3%).

    Three patients developed peri-procedure complications: oxygen desaturation (n = 1), hypotension (n = 1) and reduced consciousness (n = 1). There were no significant bleeding or perforation reported for this cohort. One patient presented to hospital within 8 days due to sepsis of unknown origin; readmission rate of 0.4% at 8 days. There was one death within 30 days, not attributed to the colonoscopy.

    Conclusions Our study concludes that colonoscopy is safe in very elderly patients and has low complication rates. The diagnostic yield was high and if adjusted for obstructing lesions and poor bowel preparation the caecal intubation rate was 91.5%. Elderly patients may need supervised bowel preparation to improve caecal intubation rate.


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