Evidence map›Paper›PMID 26709032›Full record

Observational studyGastroenterology2016

Risks Associated With Anesthesia Services During Colonoscopy.

Karen J Wernli, Alison T Brenner, Carolyn M Rutter, John M Inadomi

Registry-linked trialOpen access · bronzeAbstract readComparative StudyObservational StudyVideo-Audio Media
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06131905 (Magnesium Sulfate as an Adjuvant to Propofol During Consious Sedation in Adult Patients Undergoing Colonoscopy), which is not on this map. Cited by 91 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed, 6 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06131905 phase2 / phase3unknown statusnot on this mapstarted 2024, after this paper: background citation

Magnesium Sulfate as an Adjuvant to Propofol During Consious Sedation in Adult Patients Undergoing Colonoscopy

TypeinterventionalSponsorAssiut UniversityRan2024 to 2025Enrolled60ConditionsMagnesium, Intraoperative AnalgesiaArmsMagnesium Sulfate, Propofol
3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 6 syntheses or guidelines pooled it, 203 citations in OpenAlex.

  1. Pooled it
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  5. Guideline
  6. No increased risk of perforation during colonoscopy in patients undergoing propofol versus traditional sedation: A meta-analysis.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2018
    Pooled it
  7. Trial
  8. Sedation reversal trends at outpatient ambulatory endoscopic centerWorld journal of gastrointestinal endoscopy · 2024
    Trial
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  11. Trial
  12. Article
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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Karen J WernliGroup Health Research Institute, Seattle, Washington; Department of Health Services, University of Washington, Seattle, Washington. Electronic address: wernli.k@ghc.org.
Alison T BrennerDepartment of Health Services, University of Washington, Seattle, Washington; Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington.
Carolyn M RutterGroup Health Research Institute, Seattle, Washington; RAND Corporation, Santa Monica, California.
John M InadomiDepartment of Health Services, University of Washington, Seattle, Washington; Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, Washington.
University of Washington · USKaiser Permanente Washington Health Research Institute · USRAND Corporation · US

Funding

Studying Colorectal Cancer Effectiveness of Screening Strategies (SuCCESS)U54CA163261 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI CHUBAK, JESSICA · 2011 to 2017
$7.3M
University of Washington Health Services Research Training ProgramT32HS013853 · AHRQ · UNIVERSITY OF WASHINGTON · PI WEINER, BRYAN J., WILLIAMS, EMILY CATERINA · 2003 to 2024
$6.9M
Improving Gastrointestinal Disease Outcomes in Vulnerable PopulationsK24DK080941 · NIDDK · UNIVERSITY OF WASHINGTON · PI INADOMI, JOHN MATTHEW · 2008 to 2019
$1.8M
UW Centers for Comparative and Health Systems Effectiveness Training ProgramK12HS019482 · AHRQ · UNIVERSITY OF WASHINGTON · PI SULLIVAN, SEAN D · 2010 to 2010
$1.6M
AHRQ HHS 5 T32 HS 13853-9AHRQ HHS K12 HS019482AHRQ HHS T32 HS013853NCI NIH HHS U54 CA163261NIDDK NIH HHS K24 DK080941
6 · The paper itself

Abstract

BACKGROUND &

aimsWe aimed to quantify the difference in complications from colonoscopy with vs without anesthesia services.

methodsWe conducted a prospective cohort study and analyzed administrative claims data from Truven Health Analytics MarketScan Research Databases from 2008 through 2011. We identified 3,168,228 colonoscopy procedures in men and women, aged 40-64 years old. Colonoscopy complications were measured within 30 days, including colonic (ie, perforation, hemorrhage, abdominal pain), anesthesia-associated (ie, pneumonia, infection, complications secondary to anesthesia), and cardiopulmonary outcomes (ie, hypotension, myocardial infarction, stroke), adjusted for age, sex, polypectomy status, Charlson comorbidity score, region, and calendar year.

resultsNationwide, 34.4% of colonoscopies were conducted with anesthesia services. Rates of use varied significantly by region (53% in the Northeast vs 8% in the West; P < .0001). Use of anesthesia service was associated with a 13% increase in the risk of any complication within 30 days (95% confidence interval [CI], 1.12-1.14), and was associated specifically with an increased risk of perforation (odds ratio [OR], 1.07; 95% CI, 1.00-1.15), hemorrhage (OR, 1.28; 95% CI, 1.27-1.30), abdominal pain (OR, 1.07; 95% CI, 1.05-1.08), complications secondary to anesthesia (OR, 1.15; 95% CI, 1.05-1.28), and stroke (OR, 1.04; 95% CI, 1.00-1.08). For most outcomes, there were no differences in risk with anesthesia services by polypectomy status. However, the risk of perforation associated with anesthesia services was increased only in patients with a polypectomy (OR, 1.26; 95% CI, 1.09-1.52). In the Northeast, use of anesthesia services was associated with a 12% increase in risk of any complication; among colonoscopies performed in the West, use of anesthesia services was associated with a 60% increase in risk.

conclusionsThe overall risk of complications after colonoscopy increases when individuals receive anesthesia services. The widespread adoption of anesthesia services with colonoscopy should be considered within the context of all potential risks.

Indexed as

AdultAnesthesiaColonoscopyDatabases, FactualFemaleHealthcare DisparitiesHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPatient SelectionProspective StudiesRisk AssessmentRisk FactorsAnesthesia ServicesEndoscopyGastroenterologyPropofol

Identifiers

PMID26709032
PMCPMC4887133
OpenAlexW2207024246

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.