title: Open-access colonoscopy: outcomes of referrals from the emergency department.
abstract: OBJECTIVE
  The study investigated the diagnostic outcome of colonoscopy referrals from the emergency department (ED) via an open-access system.
  
  
  METHODS
  A retrospective cohort study over two years was performed on all patients under 65 years referred for open-access colonoscopy by the ED in a hospital with an annual ED attendance of 140,000. Patient characteristics and presenting symptoms were retrieved. Waiting times from presentation to colonoscopy were recorded.
  
  
  RESULTS
  Over a 2-year period, 266 patients were referred, of whom 37 defaulted, leaving 229 patients who had a colonoscopy. The mean age was 48.3 ± 11.3 (SD) and the female/male ratio was 229/125. The most frequent presenting symptoms included: rectal bleeding (n = 142, 62%), change of bowel habit (n = 47, 20.5%) and abdominal pain (n = 40, 17.5%). The median waiting time from presentation to colonoscopy was 17 (range 1-69) days. A positive colonoscopic finding was recorded in 45.4%, including colorectal cancer in 12 (5.2%).
  
  
  CONCLUSIONS
  The rate of a positive diagnoses from the ED-based colonoscopy referral service was comparable to that of the general Hong Kong population. This approach may help to reduce the waiting time for colonoscopy in a specialist colorectal clinic.
authors.affiliation: Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Trauma and Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China.
authors.forename: R S Y
authors.initials: RS
authors.lastname: Wu
authors.forename: S S W
authors.initials: SS
authors.lastname: Chan
authors.forename: N K
authors.initials: NK
authors.lastname: Cheung
authors.forename: C A
authors.initials: CA
authors.lastname: Graham
authors.forename: T H
authors.initials: TH
authors.lastname: Rainer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000328:Adult; D003108:Colonic Diseases / Q000175:diagnosis*; D003113:Colonoscopy; D004636:Emergency Service, Hospital; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011349:Proctitis / Q000175:diagnosis; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D014850:Waiting Lists