ArticleClinical endoscopy2025
Risk factors for suspected infectious fever after diagnostic upper endoscopy: propofol overdose in a retrospective study from Korea.
Article in Clinical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPropofol is widely used for sedation during upper endoscopy; however, oversedation may increase the risk of complications, including aspiration pneumonia. This study aimed to determine whether propofol overdose is a risk factor for suspected postendoscopic infectious fever (SPIF).
methodsWe retrospectively analyzed 1,474 in-patients who underwent upper endoscopy at Inha University Hospital between October 2021 and October 2022. After excluding 400 patients who received interventional procedures, SPIF was defined as new-onset fever (≥38 °C) within three days post-endoscopy with at least one of the following: intravenous antibiotic initiation, leukocytosis (white blood cell≥10,000/mm³), positive blood or sputum cultures, or pneumonia on chest X-ray. The risk factors assessed included comorbidities, sedative type and dosage, procedure duration, and endoscopist's experience.
resultsNew-onset fever occurred in 40 patients (3.7%), with 20 (1.9%) meeting SPIF criteria. Multivariable analysis showed propofol overdose (>2.2 mg/kg) significantly increased risks of new-onset fever (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.00-1.06; p=0.023) and SPIF (OR, 1.04; 95% CI, 1.00-1.04; p=0.034). Dementia (OR, 1.11, p<0.001) and prolonged procedure (>5 minutes; OR, 1.01; p=0.012) were also risk factors for SPIF.
conclusionsPropofol overdose significantly increases the risk of SPIF. Careful sedation management is essential, especially for patients with dementia or prolonged procedures.
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