Colonoscopy completion and complication rates in a community gastroenterology practice.
BACKGROUND
In the United States, colonoscopy completion and complication rates are rarely reported outside academic institutions. Increased transparency of quality measures and outcomes is being driven by professional societies, government agencies, and private enterprise.


OBJECTIVE
To collect and report the completion and complication rates of colonoscopy in a community gastroenterology practice.


METHODS
Single-center study, prospective for completion, retrospective for complications.


METHODS
Community gastroenterology group practice, conducted from August 2002 through December 2004.


METHODS
A total of 12,407 consecutive patients referred for colonoscopy; mean age, 59.7 years; 5925 men.


METHODS
Polypectomy and cautery were completed as indicated.


METHODS
Completion of colonoscopy to cecum or ileocolonic anastomosis. Complications of hemorrhage and perforation.


RESULTS
A colonoscopy was completed in 98.4% of patients. Polypectomy was accomplished in 5074 (40.9%). Polyps occurred more often in men (46.4% vs 35.8%, P < .001). Causes for failure included difficult anatomy (55.9%), inadequate preparation (20.8%), obstructing malignancy (8.6%), discomfort (8.1%), and severe inflammation (6.1%). Failure from difficult anatomy was more likely in women (1.19% vs 0.56%, P < .001). Hemorrhage requiring hospitalization occurred after 25 cases (0.20%). Twenty-three episodes of bleeding occurred after polypectomy (0.46%) and 2 after treatment of arteriovenous malformations. Two perforations occurred (0.016%). One patient developed a posterior circulation stroke. No deaths occurred.


CONCLUSIONS
Completion not independently verifiable. Complications were collected retrospectively.


CONCLUSIONS
Colonoscopy completion and complication rates in this community gastroenterology practice compared favorably with U.S. academic centers. Endoscopic quality in community practices can meet published outcomes.
Rathgaber
Scott W
SW
Department of Gastroenterology, Gundersen Lutheran Medical Center, La Crosse, Wisconsin 54601, USA.
Wick
Theresa M
TM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000209:etiology; D003108:Colonic Diseases / Q000453:epidemiology / Q000209:etiology; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D003113:Colonoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D005762:Gastroenterology / Q000706:statistics & numerical data; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006123:Group Practice / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors