Colonoscopy in the elderly. Low risk, high yield.
An evaluation of the utility, morbidity, and patient tolerance of colonoscopy in elderly (> or = 70 years) patients was undertaken and compared to data for a similar group of younger patients (50-70 years) who underwent colonoscopy during the same 48 months. Data reviewed for both groups included demographics, indications for colonoscopy, effectiveness of bowel preparation, colonoscopy completion, endoscopic findings, and complications. The mean age of the entire 656-patient population was 69 +/- 10 years; 87 (25%) of the 354 elderly patients were greater than 80 years of age and the average age of the 302-member control group was 59.8 +/- 5.8 years. Indications for colonoscopy were the same in both groups and included rectal bleeding, 134 (20%); prior colorectal operation, 115 (18%); a history of adenomatous polyps, 82 (12%); guaiac-positive stools, 49 (8%); abnormal finding on barium enema, 19 (3%); and miscellaneous other gastrointestinal symptoms, 151 (23%). Screening colonoscopy was performed in 106 (16%). Colonoscopy was successfully completed to the cecum or the ileocolic anastomosis in 85% (555/656) of the entire population. Only 78% (275/354) of elderly patients had colonoscopy successfully completed compared to 93% (281/302) of their younger counterparts (P = 0.001). Elderly patients were significantly more likely to have an abnormality than younger patients (74% vs 60%, P < 0.05). Malignant colorectal neoplasia was more common in the elderly (6% vs 2%, P = 0.03); however, benign neoplasia was equally present in both age groups (30% vs 27%, P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Department of Surgery, St. Louis University School of Medicine, MO 63110-0250, USA.
Dehghan
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K
Vernava
A M
AM
Longo
W E
WE
Andrus
C A
CA
Daniel
G L
GL
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000175:diagnosis*; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011446:Prospective Studies