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A national study of cardiopulmonary unplanned events after GI endoscopy.

Abstract：

BACKGROUND:Cardiopulmonary unplanned events (CUE) related to conscious sedation constitute a major proportion of GI endoscopy-associated complications. OBJECTIVES:Our purpose was to study the incidence of CUE during GI endoscopy and to determine factors that may predict CUE. DESIGN:Retrospective CORI (Clinical Outcomes Research Initiative) database review. PATIENTS:Undergoing GI endoscopy under conscious sedation. MAIN OUTCOME MEASUREMENT:CUE associated with GI endoscopy. RESULTS:Data on 324,737 unique procedures (EGD, 140,692; colonoscopy, 174,255; ERCP, 6092; and EUS, 3698) performed with the patient under conscious sedation were analyzed. Unplanned events were reported in 1.4% of procedures; 0.9% were associated with CUE. Rates of CUE with EGD, colonoscopy, ERCP, and EUS were 0.6%, 1.1%, 2.1%, and 0.9%, respectively. Multiple logistic regression revealed patient age (odds ratio [OR] 1.02, 95% CI 1.01-1.02) and ASA class were significant predictors of CUE (OR compared with ASA I: ASA II 1.05, 95% CI 0.95-1.16; ASA III 1.8, 95% CI 1.6-2.0, ASA IV 3.2, 95% CI 2.5-4.1, ASA V 7.5; 95% CI 3.2-17.6). Inpatient procedures were associated with higher CUE (OR 1.5, 95% CI 1.3-1.7). Compared with universities, nonuniversity sites (OR 1.2, 95% CI 1.1-1.4) and Veterans Administration Medical Centers (OR 1.4, 95% CI 1.2-1.5) had significantly higher CUE. Use of supplemental oxygen during a procedure was associated with significantly more CUE (OR 1.2, 95% CI 1.1-1.3). Involvement of a trainee with a procedure was also associated with higher CUE (OR 1.3, 95% CI 1.1-1.4). LIMITATIONS:Retrospective review of data entered voluntarily by endoscopists not trained on CORI data entry. CONCLUSIONS:During GI endoscopy with conscious sedation, patient's age, higher ASA grade, inpatient status, trainee participation, and routine use of oxygen are associated with a higher incidence of CUE.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Sharma VK,Nguyen CC,Crowell MD,Lieberman DA,de Garmo P,Fleischer DE

doi

10.1016/j.gie.2006.12.040

subject

Has Abstract

pub_date

2007-07-01 00:00:00

pages

27-34

issue

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(06)03552-8

journal_volume

pub_type

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A national study of cardiopulmonary unplanned events after GI endoscopy.