title: Canadian Association of Gastroenterology Indicators of Safety Compromise following Colonoscopy in Clinical Practice.
abstract: In 2012 the Canadian Association of Gastroenterology published 19 indicators of safety compromise. We studied the incidence of these indicators by reviewing all colonoscopies performed in St. John's, NL, between January 1, 2012, and June 30, 2012. Results. A total of 3235 colonoscopies were included. Adverse events are as follows. Medication-related includes use of reversal agents 0.1%, hypoxia 9.9%, hypotension 15.4%, and hypertension 0.9%. No patients required CPR or experienced allergic reactions or laryngospasm/bronchospasm. The indicator, "sedation dosages in patients older than 70," showed lower usage of fentanyl and midazolam in elderly patients. Procedure-related immediate includes perforation 0.2%, immediate postpolypectomy bleeding 0.3%, need for hospital admission or transfer to the emergency department 0.1%, and severe persistent abdominal pain proven not to be perforation 0.4%. Instrument impaction was not seen. Procedure-related delayed includes death within 14 days 0.1%, unplanned health care visit within 14 days of the colonoscopy 1.8%, unplanned hospitalization within 14 days of the colonoscopy 0.6%, bleeding within 14 days of colonoscopy 0.2%, infection 0.03%, and metabolic complication 0.03%. Conclusions. The most common adverse events were mild and sedation related. Rates of serious adverse events were in keeping with published reports.
authors.affiliation: Department of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Borgaonkar
authors.affiliation: Department of Surgery, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: David
authors.initials: D
authors.lastname: Pace
authors.affiliation: Faculty of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Muna
authors.initials: M
authors.lastname: Lougheed
authors.affiliation: Faculty of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Curtis
authors.initials: C
authors.lastname: Marcoux
authors.affiliation: Faculty of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Bradley
authors.initials: B
authors.lastname: Evans
authors.affiliation: Department of Surgery, Dalhousie University, Halifax, NS, Canada B3H 4R2.
authors.forename: Nikita
authors.initials: N
authors.lastname: Hickey
authors.affiliation: Department of Obstetrics and Gynecology, Queen's University, Kingston, ON, Canada K7L 3 3N62.
authors.forename: Meghan
authors.initials: M
authors.lastname: O'Leary
authors.affiliation: Department of Medicine, Memorial University, St. John's, NL, Canada A1B 3V6.
authors.forename: Jerry
authors.initials: J
authors.lastname: McGrath
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000009:adverse effects / Q000592:standards / Q000706:statistics & numerical data*; D016292:Procedural Sedation / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D009523:Newfoundland and Labrador / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012449:Safety / Q000706:statistics & numerical data*
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam; D005283:Fentanyl