Safety and feasibility of colonoscopy in nonagenarians : A systematic review, meta-analysis and meta-regression analysis
© 2024 Association of Coloproctology of Great Britain and Ireland..
AIM: The aim of this work was to evaluate the safety and feasibility of performing colonoscopy in patients aged 90 years or over.
METHOD: In compliance with PRISMA statement standards, a systematic review of studies reporting the outcomes of colonoscopy in patients aged ≥90 years was conducted. A proportional meta-analysis model was constructed to quantify the risk of outcomes and a direct comparison meta-analysis model was constructed to compare outcomes between nonagenarians and patients aged between 50 and 89 years via random-effects models.
RESULTS: Seven studies enrolling 1304 patients (1342 colonoscopies) were included. Analyses showed that complications related to bowel preparation occurred in 0.7% (95% CI 0.1%-1.6%), procedural complications in 0.6% (0.00%-1.7%), 30-day complications in 1.5% (0.6%-2.7%), procedural mortality in 0.3% (0.0%-1.1%) and 30-day mortality in 1.1% (0.3%-2.2%). Adequate bowel preparation and colonoscopy completion were achieved in 81.3% (73.8%-87.9%) and 92.1% (86.7%-96.3%), respectively. No difference was found in bowel preparation-related complications [risk difference (RD) 0.00, p = 0.78], procedural complications (RD 0.00, p = 0.60), 30-day complications (RD 0.01, p = 0.20), procedural mortality (RD 0.00, p = 1.00) or 30-day mortality (RD 0.01, p = 0.34) between nonagenarians and patients aged between 50 and 89 years. The colorectal cancer detection rate was 14.3% (9.8%-19.5%), resulting in therapeutic intervention in 65.9% (54.5%-76.6%).
CONCLUSIONS: Although the evidence is limited to a selected group of nonagenarians, it may be fair to conclude that if a colonoscopy is indicated in a nonagenarian with good performance status (based on initial less-invasive investigations), the level 2 evidence supports its safety and feasibility. Age on its own should not be a reason for failing to offer colonoscopy to a nonagenarian.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland - (2024) vom: 25. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Hajibandeh, Shahab [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 25.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1111/codi.16960 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370174968 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370174968 | ||
| 003 | DE-627 | ||
| 005 | 20240327000601.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240327s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/codi.16960 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1349.xml |
| 035 | |a (DE-627)NLM370174968 | ||
| 035 | |a (NLM)38527938 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Hajibandeh, Shahab |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Safety and feasibility of colonoscopy in nonagenarians |b A systematic review, meta-analysis and meta-regression analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 25.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024 Association of Coloproctology of Great Britain and Ireland. | ||
| 520 | |a AIM: The aim of this work was to evaluate the safety and feasibility of performing colonoscopy in patients aged 90 years or over | ||
| 520 | |a METHOD: In compliance with PRISMA statement standards, a systematic review of studies reporting the outcomes of colonoscopy in patients aged ≥90 years was conducted. A proportional meta-analysis model was constructed to quantify the risk of outcomes and a direct comparison meta-analysis model was constructed to compare outcomes between nonagenarians and patients aged between 50 and 89 years via random-effects models | ||
| 520 | |a RESULTS: Seven studies enrolling 1304 patients (1342 colonoscopies) were included. Analyses showed that complications related to bowel preparation occurred in 0.7% (95% CI 0.1%-1.6%), procedural complications in 0.6% (0.00%-1.7%), 30-day complications in 1.5% (0.6%-2.7%), procedural mortality in 0.3% (0.0%-1.1%) and 30-day mortality in 1.1% (0.3%-2.2%). Adequate bowel preparation and colonoscopy completion were achieved in 81.3% (73.8%-87.9%) and 92.1% (86.7%-96.3%), respectively. No difference was found in bowel preparation-related complications [risk difference (RD) 0.00, p = 0.78], procedural complications (RD 0.00, p = 0.60), 30-day complications (RD 0.01, p = 0.20), procedural mortality (RD 0.00, p = 1.00) or 30-day mortality (RD 0.01, p = 0.34) between nonagenarians and patients aged between 50 and 89 years. The colorectal cancer detection rate was 14.3% (9.8%-19.5%), resulting in therapeutic intervention in 65.9% (54.5%-76.6%) | ||
| 520 | |a CONCLUSIONS: Although the evidence is limited to a selected group of nonagenarians, it may be fair to conclude that if a colonoscopy is indicated in a nonagenarian with good performance status (based on initial less-invasive investigations), the level 2 evidence supports its safety and feasibility. Age on its own should not be a reason for failing to offer colonoscopy to a nonagenarian | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a colonoscopy | |
| 650 | 4 | |a elderly | |
| 650 | 4 | |a nonagenarian | |
| 650 | 4 | |a safety | |
| 700 | 1 | |a Hajibandeh, Shahin |e verfasserin |4 aut | |
| 700 | 1 | |a Regan, Azel |e verfasserin |4 aut | |
| 700 | 1 | |a Waterman, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Stewart, Christopher M B |e verfasserin |4 aut | |
| 700 | 1 | |a Ansell, James |e verfasserin |4 aut | |
| 700 | 1 | |a Horwood, James |e verfasserin |4 aut | |
| 700 | 1 | |a Phillips, Simon |e verfasserin |4 aut | |
| 700 | 1 | |a Davies, Michael |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland |d 1999 |g (2024) vom: 25. März |w (DE-627)NLM125460759 |x 1463-1318 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:25 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/codi.16960 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 25 |c 03 | ||