title: Prevalence and lifetime risk of endoscopy-related complications among patients with inflammatory bowel disease.
abstract: OBJECTIVE
  Few studies have analyzed the safety of endoscopy in patients with inflammatory bowel disease (IBD). We aimed to determine the prevalence of procedure-related complications among these patients, compared with the general population, and estimate the lifetime risk of colonoscopy-related complications.
  
  
  METHODS
  We collected data on complications in 685 patients with IBD and 17,000 patients without IBD (controls) using an automated system to track all emergency department visits to the Beth Israel Deaconess Medical Center within 14 days of an endoscopic procedure, from March 1, 2007, to November 30, 2007. We reviewed charts of all IBD patients to determine health care use (telephone calls or visits to a gastroenterologist or primary care physician and visits to other emergency departments or hospitals) after endoscopy. The lifetime risk of procedure-related complications was estimated using a Markov Monte Carlo model.
  
  
  RESULTS
  Rates of complications were 1.17% among patients with IBD and 0.96% among controls (P = .55). The chart review showed that 3.8% of the IBD cohort received medical care within 14 days of the endoscopic procedure. Based on a Markov Monte Carlo simulation model, the lifetime risk of complications after a surveillance colonoscopy protocol was 12.7% among patients with IBD and 2.0% in the general population undergoing screening colonoscopy (P < .001).
  
  
  CONCLUSIONS
  Although the risk of adverse events after each endoscopic procedure was similar for patients with IBD and the general population, IBD patients have an increased lifetime risk of complications after colonoscopies. A higher percentage of patients with IBD also seek medical care after endoscopic procedures than controls.
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Electronic address: jferreira2@lifespan.org.
authors.forename: Jason
authors.initials: J
authors.lastname: Ferreira
authors.forename: Mona
authors.initials: M
authors.lastname: Akbari
authors.forename: Laurie
authors.initials: L
authors.lastname: Gashin
authors.forename: Garret
authors.initials: G
authors.lastname: Cullen
authors.forename: Alan
authors.initials: A
authors.lastname: Moss
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leffler
authors.forename: Mark
authors.initials: M
authors.lastname: Aronson
authors.forename: Adam S
authors.initials: AS
authors.lastname: Cheifetz
mesh_terms: D015331:Cohort Studies; D003113:Colonoscopy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment
keywords: BIDMC; Beth Israel Deaconess Medical Center; CI; Colitis; Crohn's Disease; ED; EGD; Endoscopy Safety; IBD; Mathematic Model; UC; confidence interval; emergency department; esophagogastroduodenoscopy; inflammatory bowel disease; ulcerative colitis