Risks, indications and technical aspects of colonoscopy in elderly or frail patients. Position paper of the Societat Catalana de Digestologia, the Societat Catalana de Geriatria i Gerontologia and the Societat Catalana de Medicina de Familia i Comunitaria
Gastroenterol Hepatol. 2024 Jan;47(1):107-117.
doi: 10.1016/j.gastrohep.2023.05.004.
Epub 2023 May 18.
[Article in
English,
Spanish]
Affiliations
- 1 Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
- 2 Servei de Medicina Interna, Unitat de Geriatria, Hospital de Sant Pau, Barcelona, España.
- 3 CAP Florida Sud, Institut Català de La Salut, Hospitalet de Llobregat, España; Departament de Ciències Clíniques, Facultat de Medicina, Universitat de Barcelona, Barcelona, España.
- 4 Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España.
- 5 CAP La Mina, Institut Català de La Salut, Sant Adrià de Besòs, España.
- 6 Servei de Geriatria i Cures Pal·liatives, Hospital de la Santa Creu Jesús, Tortosa, España.
- 7 Servei Aparell Digestiu, Hospital de Sant Pau, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España.
- 8 CAP Onze de Setembre, Institut Català de la Salut, Lleida, España.
- 9 Servei d'Aparell Digestiu, Consorci Sanitari de Terrassa, Terrassa, España.
- 10 Servei d'Aparell Digestiu, Parc Taulí, Hospital Universitari, Institut de Recerca Parc Taulí, Sabadell, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; CIBEREHD, Instituto de Salud Carlos III, Madrid, España. Electronic address: xcalvet@tauli.cat.
Abstract
Colonoscopy (CS) is an invasive diagnostic and therapeutic technique, allowing the study of the colon. It is a safe and well tolerated procedure. However, CS is associated with an increased risk of adverse events, insufficient preparation and incomplete examinations in the elderly or frail patient (PEA/F). The objective of this position paper was to develop a set of recommendations on risk assessment, indications and special care required for CS in the PEA/F. It was drafted by a group of experts appointed by the SCD, SCGiG and CAMFiC that agreed on eight statements and recommendations, between them to recommend against performing CS in patients with advanced frailty, to indicate CS only if the benefits clearly outweigh the risks in moderate frailty and to avoid repeating CS in patients with a previous normal procedure. We also recommended against performing screening CS in patients with moderate or advanced frailty.
Keywords:
Colonoscopia; Colonoscopy; Edada avanzada; Elderly; Frail patient; Paciente con fragilidad.
Copyright © 2023 Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Aged
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Colonoscopy / methods
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Frail Elderly
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Frailty* / diagnosis
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Humans
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Risk Assessment