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- Title
Safety and feasibility of colonoscopy in nonagenarians: A systematic review, meta‐analysis and meta‐regression analysis.
- Authors
Hajibandeh, Shahab; Hajibandeh, Shahin; Regan, Azel; Waterman, Jennifer; Stewart, Christopher M. B.; Ansell, James; Horwood, James; Phillips, Simon; Davies, Michael
- Abstract
Aim: The aim of this work was to evaluate the safety and feasibility of performing colonoscopy in patients aged 90 years or over. Method: In compliance with PRISMA statement standards, a systematic review of studies reporting the outcomes of colonoscopy in patients aged ≥90 years was conducted. A proportional meta‐analysis model was constructed to quantify the risk of outcomes and a direct comparison meta‐analysis model was constructed to compare outcomes between nonagenarians and patients aged between 50 and 89 years via random‐effects models. Results: Seven studies enrolling 1304 patients (1342 colonoscopies) were included. Analyses showed that complications related to bowel preparation occurred in 0.7% (95% CI 0.1%–1.6%), procedural complications in 0.6% (0.00%–1.7%), 30‐day complications in 1.5% (0.6%–2.7%), procedural mortality in 0.3% (0.0%–1.1%) and 30‐day mortality in 1.1% (0.3%–2.2%). Adequate bowel preparation and colonoscopy completion were achieved in 81.3% (73.8%–87.9%) and 92.1% (86.7%–96.3%), respectively. No difference was found in bowel preparation‐related complications [risk difference (RD) 0.00, p = 0.78], procedural complications (RD 0.00, p = 0.60), 30‐day complications (RD 0.01, p = 0.20), procedural mortality (RD 0.00, p = 1.00) or 30‐day mortality (RD 0.01, p = 0.34) between nonagenarians and patients aged between 50 and 89 years. The colorectal cancer detection rate was 14.3% (9.8%–19.5%), resulting in therapeutic intervention in 65.9% (54.5%–76.6%). Conclusions: Although the evidence is limited to a selected group of nonagenarians, it may be fair to conclude that if a colonoscopy is indicated in a nonagenarian with good performance status (based on initial less‐invasive investigations), the level 2 evidence supports its safety and feasibility. Age on its own should not be a reason for failing to offer colonoscopy to a nonagenarian.
- Subjects
NONAGENARIANS; COLONOSCOPY; BOWEL preparation (Procedure); EARLY detection of cancer; COLORECTAL cancer; VIRTUAL colonoscopy
- Publication
Colorectal Disease, 2024, Vol 26, Issue 5, p871
- ISSN
1462-8910
- Publication type
Article
- DOI
10.1111/codi.16960