title: Onset and clinical course of bleeding and perforation after outpatient colonoscopy: a population-based study.
abstract: BACKGROUND
  Endoscopists are advised to measure and report their rates of colonoscopy-associated perforation and bleeding. However, evidence from population-based studies is lacking on the time period over which monitoring is needed to detect these adverse events.
  
  
  OBJECTIVE
  To determine the time course of perforation or bleeding requiring hospital admission within 30 days after outpatient colonoscopy.
  
  
  METHODS
  Population-based cohort study.
  
  
  METHODS
  Ontario, Canada.
  
  
  METHODS
  Men and women, 50 to 75 years old who underwent an outpatient colonoscopy during the period from April 1, 2002 to March 31, 2003.
  
  
  METHODS
  Hospitalization for colonoscopy-related perforation or bleeding within 30 days after the procedure.
  
  
  RESULTS
  We identified 67,632 patients who had an outpatient colonoscopy, of whom 37 were admitted for hospitalization with perforation and 83 with bleeding within 30 days after the procedure. For those with a perforation, 34 of 37 (92%) were admitted within 2 days and all within 5 days. For those with bleeding, 30 of 83 (36%) were admitted within 2 days and 80 of 83 (96%) within 14 days.
  
  
  CONCLUSIONS
  Lack of information on medication use.
  
  
  CONCLUSIONS
  After outpatient colonoscopy, use of a 14-day time period for reporting would capture all perforations and the majority (96%) of bleeds requiring hospital admission.
authors.affiliation: Department of Medicine, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Rabeneck
authors.forename: Refik
authors.initials: R
authors.lastname: Saskin
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Paszat
mesh_terms: D000368:Aged; D001803:Blood Transfusion; D015331:Cohort Studies; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010045:Outpatients / Q000706:statistics & numerical data*; D013997:Time Factors