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Abstract
Colonoscopy is the standard investigation for colonic disease, but clinicians often
are reluctant to refer elderly patients for colonoscopy because of a perception of
higher risk and a high rate of incomplete examinations.
Data were prospectively collected on 924 consecutive colonoscopies performed over
a 31-month period. Comparisons were made between two groups: patients 80 years of
age or older (Group O) and patients less than 80 years of age (Group Y). Data were
collected on sedation, crude and adjusted total colonoscopy rates, ileoscopy rate,
anus to cecum time, total procedure time, diagnostic yield, and complications. Appropriate
exclusions were made to calculate procedure success rates and time.
Patients in Group O (n=110) received significantly less sedative medication compared
with Group Y (n=814) (median dosage for midazolam, 1 mg vs. 2.5 mg; median dosage
for meperidine, 12.5 vs. 25 mg; p < 0.0001). The adjusted total colonoscopy rate was
97% and 99.2% for Group O and Group Y (not significant), respectively. Ileoscopy rate
was significantly lower in Group O (71.1% vs. 86.1%; p=0.0004). Median anus to cecum
time was significantly longer in Group O (9.75 vs. 8.5 minutes; p=0.0182) in a single
test of hypothesis; however, Bonferroni correction for multiple testing of data removes
this significance. Median total procedure time also was longer in Group O (22 vs.
18.5 minutes; p=0.0001). Diagnostic yield was high, and the complication rate was
low for both groups. Colorectal cancer was detected in 20% patients in Group O and
7.4% in Group Y (p < 0.0001).
Colonoscopy in patients 80 or more years of age is safe, effective, and has a high
diagnostic yield. Procedure times are slightly longer, and the ileoscopy rate is lower
in this age group.