Introduction With the introduction of national bowel cancer screening and increased surveillance, colonoscopy is being increasingly used as both a diagnostic and therapeutic tool. It is deemed a relatively safe procedure with the overall complication rate being reported at approximately 0.1%. However, it was recently reported in a study from the USA that procedure related hospital attendances within 14 days of colonoscopy were as high as 0.84%.1
Methods The aim of this study was to identify the true morbidity and related healthcare costs after outpatient colonoscopy in a UK population. We performed an observational study of hospital visits occurring within 14 days of colonoscopy at West Middlesex University Hospital, London. We collected data from 2011, using the hospitals' electronic records system, enterpriseCAMIS®. Cases meeting the predetermined criteria were analysed to assess whether presentations could be attributed to the colonoscopy, and overall healthcare costs were determined.
Results Over the 12-month period, 1115 outpatient colonoscopies were performed; the Abstract OC-013 table 1 below summarises the number of hospital visits occurring within 14 days and associated healthcare costs. Of the 1115 colonoscopies performed, there were 22 visits to the A&E department within 14 days; 14 of these visits were procedure-related, with five requiring admission. Abdominal pain was the commonest reason for emergency attendance, with bleeding, perforation, post-polypectomy syndrome, sedation and other gastro-intestinal causes accounting for the remaining. The average cost for patients attending A&E was £145; £3338 for those requiring admission; working out as a total cost of £18 720 over the 12-month period.
Conclusion Outpatient colonoscopy is an essential diagnostic and therapeutic tool. However, data on the overall morbidity burden is limited. With a 1.25% incidence of emergency attendances within 14 days of colonoscopy and significant associated healthcare costs, this study supports recently published data from the USA and highlights the importance of recognising these complications within a UK population.
Competing interests None declared.
Reference 1. Leffler, et al. The incidence and cost of unexpected hospital use after scheduled outpatient endoscopy. Arch Intern Med 2010;170:1752–7.