Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data

Background and study aims: Analyses of colonoscopy (CS) and esophagogastroduodenoscopy (EGD) complications is crucial for further promoting the use of endoscopy. This study analyzed the rates of severe complications of CS compared to those of EGD using big data. Patients and methods: As a study pop...

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Main Authors: Naohisa Yoshida, Hideki Ishikawa, Michihro Mutoh, Naoto Iwai, Reo Kobayashi, Ken Inoue, Ryohei Hirose, Osamu Dohi, Yoshito Itoh, Azusa Yoda, Ayako Maeda-Minami, Yasunari Mano
Format: Article
Language:English
Published: Georg Thieme Verlag KG
Series:Endoscopy International Open
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/a-2689-6049
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author Naohisa Yoshida
Hideki Ishikawa
Michihro Mutoh
Naoto Iwai
Reo Kobayashi
Ken Inoue
Ryohei Hirose
Osamu Dohi
Yoshito Itoh
Azusa Yoda
Ayako Maeda-Minami
Yasunari Mano
author_facet Naohisa Yoshida
Hideki Ishikawa
Michihro Mutoh
Naoto Iwai
Reo Kobayashi
Ken Inoue
Ryohei Hirose
Osamu Dohi
Yoshito Itoh
Azusa Yoda
Ayako Maeda-Minami
Yasunari Mano
author_sort Naohisa Yoshida
collection DOAJ
description Background and study aims: Analyses of colonoscopy (CS) and esophagogastroduodenoscopy (EGD) complications is crucial for further promoting the use of endoscopy. This study analyzed the rates of severe complications of CS compared to those of EGD using big data. Patients and methods: As a study population, we retrospectively used commercially anonymized health insurance claims data covering 3,050,954 patients from January 2010 to December 2020. Patients ≥50 years old who underwent CS or EGD without treatment were included in the study. The main outcomes were the difference in rates of hemorrhage, perforation, and fatal events between EGD and CS, and the risk factors of each complication comparing CS to EGD. Results: Among 290,470 CSs (male: 182,910, female: 107,560, median age [range]: 58 [50-75]) and 726,075 EGDs (male: 412,365, female: 313,710, 58 [50-75]), the rates of hemorrhage, perforation, and fatal events for EGD and CS were 0.0069% vs. 0.0069% (p=0.558), 0.0006% vs. 0.0024% (p=0.008), and 0.00028% vs. 0.00034% (p=0.648), respectively. The rates of hemorrhage for cases 50-64 and 65-75 years old were 0.0059% vs. 0.0110% (p=0.042) for EGD and 0.0061% vs. 0.0108% for CS (p=0.264). The risks of hemorrhage (adjusted odds ratio [95% confidence interval]) for comparing CS to EGD were significant for biopsy (2.75 [1.15-6.21], p=0.017) and antithrombotics (12.48 [1.80-247.14], p=0.026). Those of perforation were significant for age 50-64 (9.58 [2.17-66.10], p=0.006) and male (11.76 [1.85-222.65], p=0.025). Conclusions: Compared to EGD, CS showed a higher rate of perforation but not hemorrhage. Complication rates in CS did not differ by age.
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spelling doaj-art-53cb4347ca2d4e69aa66bcef3237c7a02025-08-25T23:14:46ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-973610.1055/a-2689-6049Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims dataNaohisa Yoshida0https://orcid.org/0000-0001-6167-9705Hideki Ishikawa1Michihro Mutoh2Naoto Iwai3Reo Kobayashi4Ken Inoue5Ryohei Hirose6Osamu Dohi7https://orcid.org/0000-0002-0498-0144Yoshito Itoh8Azusa Yoda9Ayako Maeda-Minami10Yasunari Mano11Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of MedicineMolecular-Targeting Cancer Prevention, Kyoto Prefectual University of Medicine, Osaka, JapanKyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, JapanGastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, JapanMolecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, JapanDepartment of Gastroenterology and Hepatology, Kyoto Furitsu Ika Daigaku, Kyoto, JapanMolecular of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanTokyo University of Science, Chiba, JapanTokyo University of Science, Chiba, JapanTokyo University of Science, Chiba, JapanBackground and study aims: Analyses of colonoscopy (CS) and esophagogastroduodenoscopy (EGD) complications is crucial for further promoting the use of endoscopy. This study analyzed the rates of severe complications of CS compared to those of EGD using big data. Patients and methods: As a study population, we retrospectively used commercially anonymized health insurance claims data covering 3,050,954 patients from January 2010 to December 2020. Patients ≥50 years old who underwent CS or EGD without treatment were included in the study. The main outcomes were the difference in rates of hemorrhage, perforation, and fatal events between EGD and CS, and the risk factors of each complication comparing CS to EGD. Results: Among 290,470 CSs (male: 182,910, female: 107,560, median age [range]: 58 [50-75]) and 726,075 EGDs (male: 412,365, female: 313,710, 58 [50-75]), the rates of hemorrhage, perforation, and fatal events for EGD and CS were 0.0069% vs. 0.0069% (p=0.558), 0.0006% vs. 0.0024% (p=0.008), and 0.00028% vs. 0.00034% (p=0.648), respectively. The rates of hemorrhage for cases 50-64 and 65-75 years old were 0.0059% vs. 0.0110% (p=0.042) for EGD and 0.0061% vs. 0.0108% for CS (p=0.264). The risks of hemorrhage (adjusted odds ratio [95% confidence interval]) for comparing CS to EGD were significant for biopsy (2.75 [1.15-6.21], p=0.017) and antithrombotics (12.48 [1.80-247.14], p=0.026). Those of perforation were significant for age 50-64 (9.58 [2.17-66.10], p=0.006) and male (11.76 [1.85-222.65], p=0.025). Conclusions: Compared to EGD, CS showed a higher rate of perforation but not hemorrhage. Complication rates in CS did not differ by age. http://www.thieme-connect.de/DOI/DOI?10.1055/a-2689-6049
spellingShingle Naohisa Yoshida
Hideki Ishikawa
Michihro Mutoh
Naoto Iwai
Reo Kobayashi
Ken Inoue
Ryohei Hirose
Osamu Dohi
Yoshito Itoh
Azusa Yoda
Ayako Maeda-Minami
Yasunari Mano
Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
Endoscopy International Open
title Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
title_full Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
title_fullStr Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
title_full_unstemmed Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
title_short Difference in the complications between colonoscopy and esophagogastroduodenoscopy in Japan using a large-scale health insurance claims data
title_sort difference in the complications between colonoscopy and esophagogastroduodenoscopy in japan using a large scale health insurance claims data
url http://www.thieme-connect.de/DOI/DOI?10.1055/a-2689-6049
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