Perforations and bleeding in a population-based cohort of all registered colonoscopies in Sweden from 2001 to 2013

United European Gastroenterology Journal
Torbjörn ThulinAnna M Forsberg

Abstract

The rates of perforation and bleeding are important quality measures of colonoscopy performance. The objective of this article is to assess the frequency of colonoscopy-related bleeding and perforation in Swedish counties and to relate these findings to patient characteristics. Data on 593,308 colonoscopies performed on adults from 2001 to 2013 were retrieved from Swedish inpatient and outpatient registers. Covariates were assessed in a multivariate Poisson regression model. The correlation between perforation and bleeding was calculated with Pearson's bivariate correlation formula. The relative frequency of bleeding and perforation vary across counties (bleeding: 0.02%-0.27%; perforation: 0.02%-0.27%). There were significant positive correlations between the relative frequency of bleeding and perforation at the county level, both including (r = 0.792, p < 0.001) and excluding polypectomies r = 0.814 (p < 0.001). The relative risks of these conditions in the counties ranged from 0.12, p < 0.001, to 1.53, p = 0.05 (bleeding) and from 0.17, p = 0.002, to 2.42, p < 0.001 (perforation). There are substantial differences in colonoscopy performance in Sweden. These differences do not seem to be explained by patient characteristics.

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Citations

May 19, 2021·JAMA : the Journal of the American Medical Association·Jennifer S LinPaula R Blasi

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