title: Adverse events requiring hospitalization within 30 days after outpatient screening and nonscreening colonoscopies.
abstract: BACKGROUND
  The incidence of adverse events (AEs) is a crucial factor when colonoscopy is considered for mass screening, but few studies have addressed delayed and non-GI AEs.
  
  
  OBJECTIVE
  To investigate the risk of AEs requiring hospitalization after screening and nonscreening colonoscopies compared with control subjects who did not undergo colonoscopy.
  
  
  METHODS
  Retrospective matched cohort.
  
  
  METHODS
  Statutory health insurance fund in Germany.
  
  
  METHODS
  A total of 33,086 individuals who underwent colonoscopy as an outpatient (8658 screening, 24,428 nonscreening) and 33,086 matched controls who did not undergo colonoscopy.
  
  
  METHODS
  Outpatient screening and nonscreening colonoscopies.
  
  
  METHODS
  Risk of AEs (perforation, bleeding, myocardial infarction, stroke, splenic injury, and others) requiring hospitalization within 30 days after colonoscopy/index date and risk differences between the group that underwent colonoscopy and the group that did not.
  
  
  RESULTS
  The incidence of perforation was 0.8 (95% confidence interval [CI], 0.3-1.7) and 0.7 (95% CI, 0.4-1.1) per 1000 screening and nonscreening colonoscopies, respectively. Hospitalizations because of bleeding occurred in 0.5 (95% CI, 0.1-1.2) and 1.1 (95% CI, 0.8-1.7) per 1000 screening and nonscreening colonoscopies, respectively. The incidence of myocardial infarction, stroke, and other non-GI AEs was similar in colonoscopy and control groups. No splenic injury was observed. Those with AEs generally had a higher mean age and comorbidity rate than the overall study population.
  
  
  CONCLUSIONS
  The analysis relies on health insurance claims data.
  
  
  CONCLUSIONS
  This study provides further evidence of the safety of colonoscopy in routine practice with regard to delayed and non-GI AEs. Hospitalizations because of the investigated AEs were uncommon or rare for both screening and nonscreening colonoscopies.
authors: Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
authors: Christian
authors: C
authors: Stock
authors: Peter
authors: P
authors: Ihle
authors: Andreas
authors: A
authors: Sieg
authors: Ingrid
authors: I
authors: Schubert
authors: Michael
authors: M
authors: Hoffmeister
authors: Hermann
authors: H
authors: Brenner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D016022:Case-Control Studies; D003113:Colonoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008403:Mass Screening / Q000009:adverse effects* / Q000706:statistics & numerical data; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult