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Colonoscopy in elderly Asians: A prospective evaluation in routine clinical practice
Author(s) -
MA WeeTah,
MAHADEVA Sanjiv,
KUNANAYAGAM Soraya,
POI Philip JunHua,
GOH KheanLee
Publication year - 2007
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/j.1443-9573.2007.00289.x
Subject(s) - medicine , colonoscopy , clinical practice , prospective cohort study , general surgery , medline , emergency medicine , family medicine , colorectal cancer , political science , law , cancer
OBJECTIVE: Colonoscopy is believed to be more complicated in elderly patients in Western countries. It is uncertain if the situation holds true among Asians. This study is to determine differences in colonoscopy performance and sedation complications between patients aged <65 years and those ≥65 years of age in an Asian population. METHODS: A prospective, cross‐sectional study of adults attending outpatient colonoscopy at a tertiary institution. Clinical and endoscopic data were obtained from all consenting adults. RESULTS: Two hundred and one patients (70 elderly and 131 aged <65 years) were enrolled. Compared to the patients aged <65 years, the elderly patients had similar levels of good (42.9% vs 45.8%), satisfactory (42.9% vs 33.6%) and poor (14.3% vs 20.6%) bowel preparations ( P = NS). Cecal intubation was achieved in 60 (85.7%) of the elderly patients and 116 (88.5%) of the younger adults ( P = NS). The differences in mean total colonoscopy duration was not significant (30 ± 13 vs 27 ± 11 min). Although the elderly patients received lower mean sedation doses of midazolam (4.7 vs 5.1 mg) and pethidine (37.8 vs 46.4 mg) compared to the younger adults, the hypotension rates were significantly higher in the elderly patients (7.1% vs 0.8%, P = 0.01). The elderly patients had in additional one or more co‐morbid illnesses ( P = 0.001), with significantly higher rates of diabetes ( P = 0.004), ischemic heart disease ( P = 0.03), hypertension ( P = 0.001) and stroke disease ( P = 0.004). CONCLUSION: Colonoscopy performance in elderly Asians is similar to that in younger adults. However, the conscious sedation of these patients results in a higher rate of cardio‐vascular complications.