Colonoscopy in elderly Asians: a prospective evaluation in routine clinical practice.
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>or=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).


CONCLUSIONS
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.
Ma
Wee-Tah
WT
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Mahadeva
Sanjiv
S
Kunanayagam
Soraya
S
Poi
Philip Jun-Hua
PJ
Goh
Khean-Lee
KL
D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods*; D016292:Procedural Sedation / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies