Post-endoscopic infections are more common than previously thought, and vary widely by ambulatory surgical facility, researchers report.1
“Although screening colonoscopy is not without risk, the risk is lower than diagnostic endoscopic procedures,” they found.
With some 15 million colonoscopies and 7 million osophagogastroduodenoscopies (OGDs) performed annually in the United States, the authors sought to estimate the rates of infections after colonoscopy and OGD performed in ambulatory surgery centers (ASCs).
The researchers identified colonoscopy and OGD procedures performed at ASCs in 2014 via all-payer claims data from six states.
They tracked infection-related emergency department visits and unplanned inpatient admissions within seven and 30 days after the procedures.
In addition, they examined infection sites, organisms, and predictors of infections.
The rates of post-endoscopic infection per 1,000 procedures within seven days were 1.1 for screening colonoscopy, 1.6 for non-screening colonoscopy, and 3.0 for OGD. For comparison, the rates were higher than infections after mammography (0.6) but lower than bronchoscopy (15.6) and cystoscopy (4.4).
“Predictors of post-endoscopic infection included recent history of hospitalization or endoscopic procedure, concurrence with another endoscopic procedure, [and] low procedure volume or non-freestanding ASC,” they reported.
“Rates of 7-day post-endoscopic infections varied widely by ASC, ranging from 0 to 115 per 1,000 procedures for screening colonoscopy, 0 to 132 for non-screening colonoscopy, and 0 to 62 for OGD,” they reported.
REFERENCE
Wang P, Xu T, Ngamruengphong S, et al. Rates of infection after colonoscopy and osophagogastroduodenoscopy in ambulatory surgery centres in the USA. Gut 2018; Published Online First: 10 Apr 2018. DOI:10.1136/gutjnl-2017-315082.
Financial Disclosure: Peer Reviewer Patrick Joseph, MD, reports that he is a consultant for Genomic Health Reference Laboratory, Siemens Clinical Laboratory, and CareDx Clinical Laboratory. Senior Writer Gary Evans, Editor Jesse Saffron, Editor Jill Drachenberg, Nurse Planner Patti Grant, RN, BSN, MS, CIC, and Editorial Group Manager Terrey L. Hatcher report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.
