Introduction Gastrointestinal Endoscopy in the very elderly is generally considered risk prone and there is a degree of reluctance to perform procedures in this age group. Centenarians are people who live to or beyond 100 years of age. According to the Office of National Statistics, in 2014 there were 14,450 centenarians living in the U.K, having risen by 72% over the last decade.1It is estimated that the number of people over the age of 100 years will approximately double by 2020.2 Little is known about digestive endoscopy in the centenarians. This retrospective study aimed to explore endoscopic practice in this group of patients.
Methods A retrospective study was undertaken, analysing endoscopic practice in the centenarians in a University Hospital over a period of ten years (01/01/2005 to 01/01/2015). Endoscopy reports were retrieved using the Hospital’s Endoscopy Reporting tool (Unisoft) and patients’ Date of birth and demographic details were confirmed using the Trust’s patient database.
Results A total of 11 procedures (7 Gastroscopies, 3 sigmoidoscopies and 1 Colonoscopy) were undertaken in 10 patients (4 male and 6 female). Oldest patient was 119 years of age and the youngest 101 years. Mean age was 105.2 years. 7 patients were Caucasians, 2 Indian and 1 Afro Caribbean of ethnicity. 72% of the procedures were undertaken on an urgent basis. 70% of patients were inpatients and majority of the procedures were undertaken by Consultants (82%). Indications included Dysphagia (36.3%), Melena (27.2%), Rectal Bleeding (27.2%) and previous Cancer (9%). The procedural yield was high (81.8%) with endoscopic intervention undertaken in 2 cases (Duodenal ulcer bleeding which was treated with adrenaline injections and haemorrhoids which were banded). Only 2 of the procedures (18%) were undertaken under sedation (midazolam). All procedures were completed and no immediate complications were noted.
Conclusion To the best of the authors’ knowledge this is the only study analysing endoscopic practice in the centenarians. While we acknowledge that sample size is small it demonstrates that endoscopic procedures can be performed safely and that the diagnostic yield is high. Majority of the patients tend to be inpatients and undergo the procedure on an urgent basis by consultants.A patients’ age should not be the sole factor when deciding suitability for endoscopic procedures, bearing in mind the increasing number of centenarians requiring this service. Larger studies are required to gain a better understanding of endoscopic suitability for patients in this age group.
References 1 http://www.ons.gov.uk/ons/dcp171778_418037.pdf
Disclosure of Interest None Declared
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