Colonoscopy in the nonagenarian population

ANZ J Surg. 2023 Sep;93(9):2143-2147. doi: 10.1111/ans.18374. Epub 2023 Mar 7.

Abstract

Background: With increasing life expectancy, there is an increasing proportion of nonagenarians undergoing both elective and emergency surgical procedures. The decision as to whom will benefit from surgical procedures is however difficult to ascertain and still remains a challenge to clinicians. This study is aimed to evaluate the clinical outcomes of colonoscopy in the nonagenarian population, and to determine if the outcomes are acceptable for us to continue to offer such interventions.

Methods: Retrospective study of patients of Dr. G.R (Gastroenterologist) and Dr. W.B (Colorectal Surgeon) between 1 January 2018 and 31 November 2022. All patients who were ≥90 years old and had a colonoscopy was included in the study. Exclusion criteria were patients who were less than 90 years old, had a flexible sigmoidoscopy or colonoscopy as part of their surgical procedure.

Primary outcome measures: post-colonoscopy complications and length of stay.

Secondary outcome measures: reasons for colonoscopy, significant colonoscopy findings, 30-day morbidity and mortality.

Results: Sixty patients were included in the study. Median age was 91 (90-100) years old. 33.3% of the patients were males. Seventy percent of the patients were ASA 3. Median length of hospital stay was 1 day. 11.7% of patients were found to have colorectal malignancy. There were no complications after the colonoscopy. There were no 30-day re-admission, morbidity or mortality.

Conclusion: Colonoscopy can be performed safely in carefully selected nonagenarian patients with acceptable low complication rates.

Keywords: colonoscopy; nonagenarian.

MeSH terms

  • Aged, 80 and over
  • Colonoscopy / adverse effects
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / surgery
  • Elective Surgical Procedures / methods
  • Female
  • Humans
  • Length of Stay
  • Male
  • Nonagenarians*
  • Retrospective Studies