| Sedation in screening colonoscopy: impact on quality indicators and complications. | |
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MedLine Citation:
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PMID: 23147522 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Quality indicators including cecal intubation rate (CIR) and adenoma detection rate (ADR) are established. Sex differences of quality indicators are observed, but the influence of sedation has not been investigated so far. The objective of this study is to assess the impact of sedation on quality indicators, including CIR and ADR, according to sex. METHODS: We analyzed data of 52,506 screening colonoscopies performed by 196 endoscopists between November 2007 and April 2011 according to the Austrian "quality management for colon cancer prevention" program. RESULTS: Sedation did not affect polyp detection rate (women P=0.7972, men P=0.3711) or ADR for both sexes (women P=0.2773, men P=0.8676). ADR was not significantly influenced by sedation (P=0.1272), but by age and sex (both P<0.0001), when the executing endoscopist was considered. Although women were more often sedated than men (90.70 vs. 81.83%; P<0.0001), CIR was slightly lower in women than in men (94.69 vs. 96.58%; P<0.0001). Sedation improved the CIR in women by 2.95% (94.96 vs. 92.01%; P<0.0001), whereas in men it was just by 1.28% (96.81 vs. 95.53%; P<0.0001). Sedated women only reached the CIR of unsedated men (94.96 vs. 95.53%; P=0.1005). Accounting for the intra-observer influence of the endoscopist, the overall CIR was influenced by the interaction of sex and age (P=0.0049), but not by sedation (P=0.1435). CONCLUSIONS: Sedation does not increase adenoma or polyp detection, although it leads to an increase in CIR in men and women. This effect is more pronounced in women, yet CIR of men remains higher compared with women. Quality indicators are mainly influenced by the patient's age, sex, and the endoscopists' individual performance, rather than the endoscopists' subspeciality or procedural experience. |
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Authors:
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Christina Bannert; Karoline Reinhart; Daniela Dunkler; Michael Trauner; Friedrich Renner; Peter Knoflach; Arnulf Ferlitsch; Werner Weiss; Monika Ferlitsch |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2012-11-13 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 107 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-05 Completed Date: 2013-01-28 Revised Date: 2013-05-07 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 1837-48 Citation Subset: IM |
Affiliation:
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Quality Assurance Working Group of Austrian Society for Gastroenterology and Hepatology, Vienna, Austria. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenoma
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diagnosis Age Factors Aged Austria Clinical Competence Colonic Neoplasms / diagnosis*, prevention & control Colonic Polyps / diagnosis Colonoscopy / methods*, standards* Conscious Sedation* Female Humans Male Mass Screening / methods*, standards* Middle Aged Probability Quality Indicators, Health Care* Sex Factors |
| Comments/Corrections | |
Comment In:
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Am J Gastroenterol. 2012 Dec;107(12):1849-51
[PMID:
23211852
]
Endoscopy. 2013;45(4):305-9 [PMID: 23533077 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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