title: Safety and efficacy of colonoscopy in the elderly: experience in an innercity community hospital serving African American and Hispanic patients.
abstract: Data regarding safety and efficacy of colonoscopy in elderly African American and Hispanic patients is scarce. We designed our study to determine the safety and efficacy of colonoscopy in this population. We retrospectively reviewed records of 1530 patients, who underwent colonoscopy over a nine-year period. The population included the elderly group (age>65 years) comprising 780 patients and control group (aged < or = 65 years) comprising 750 patients. Data about cancer prevalence, complications and 30 day mortality were abstracted. The median age was 77 years (range 66-101, 61% females) for the elderly group and 57 years (range 18-65, 51% females) for controls. The elderly group required lower doses of medications for conscious sedation (P<.0001). The crude completion rate was lower for the elderly group (79.5% vs 89.7%), however the adjusted completion rate was similar in both groups (90.3% elderly vs 90.9% control). There was no significant difference in outcome between the two ethnic groups. Diagnostic yield was higher in the elderly group (69% vs 49%, P<.0001), with a significantly higher rate of cancer detection (7.9% vs 1.8%, P<.0001). There was no statistical difference in complication rate between the two groups (P=.35). There were 2 deaths within 30 days of colonoscopy: one in the elderly group, and one in the control group. Our results suggest that colonoscopy in our elderly patients was safe and effective and resulted in a high diagnostic yield. Therefore, old age alone should not deter colonoscopic evaluation when indicated.
authors.affiliation: Department of Internal Medicine, Charles Drew University of Medicine and Science, Los Angeles, CA 90059, USA. abbasiakhtar@cdrewu.edu
authors.forename: Abbasi J
authors.initials: AJ
authors.lastname: Akhtar
authors.forename: Manmeet S
authors.initials: MS
authors.lastname: Padda
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D016292:Procedural Sedation; D005260:Female; D006630:Hispanic or Latino; D006786:Hospitals, Urban; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D006993:Hypnotics and Sedatives