Differences in complications between colonoscopy and esophagogastroduodenoscopy in Japan using large-scale health insurance claims data.

IF 2.3 Q3 GASTROENTEROLOGY & HEPATOLOGY

Endoscopy International Open Pub Date : 2025-09-12 eCollection Date: 2025-01-01 DOI:10.1055/a-2689-6049

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

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Abstract

Background and study aims: Analyses of colonoscopy (CS) and esophagogastroduodenoscopy (EGD) complications is crucial for further promoting use of endoscopy. This study analyzed rates of severe complications of CS compared with 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 differences in rates of hemorrhage, perforation, and fatal events between EGD and CS, and risk factors of each complication comparing CS with 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]), 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. Rates of hemorrhage for cases aged 50 to 64 and 65 to 75 years were 0.0059% vs. 0.0110% ( P = 0.042) for EGD and 0.0061% vs. 0.0108% for CS ( P = 0.264). Risks of hemorrhage for comparing CS to EGD were significant for biopsy (adjusted odds ratio [aOR] 95% confidence interval [CI] 2.75 [1.15-6.21]; P = 0.017) and antithrombotics (aOR 12.48; 95% CI 1.80-247.14; P = 0.026). Those for perforation were significant for ages 50 to 64 years (aOR 9.58; 95% CI 2.17-66.10; P = 0.006) and male sex (11.76 [1.85-222.65], P = 0.025).

Conclusions: Compared with EGD, CS had a higher rate of perforation but not hemorrhage. Complication rates in CS did not differ by age.

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在日本使用大规模健康保险索赔数据的结肠镜检查和食管胃十二指肠镜检查之间并发症的差异

背景与研究目的：结肠镜检查（CS）和食管胃十二指肠镜检查（EGD）并发症的分析对进一步推广内镜的应用至关重要。本研究利用大数据分析了CS与EGD的严重并发症发生率。患者和方法：作为研究人群，我们回顾性地使用了商业匿名医疗保险索赔数据，涵盖了2010年1月至2020年12月的3,050,954名患者。≥50岁未接受治疗的CS或EGD患者被纳入研究。主要结局是EGD和CS之间出血、穿孔和死亡事件发生率的差异，以及CS与EGD比较每种并发症的危险因素。结果：在290,470例CSs（男性：182,910例，女性：107,560例，中位年龄[50-75]:58岁）和726,075例EGD（男性：412,365例，女性：313,710例，58例[50-75]）中，EGD和CS的出血、穿孔和致死事件发生率分别为0.0069%对0.0069% （P = 0.558）、0.0006%对0.0024% （P = 0.008）、0.00028%对0.00034% （P = 0.648）。50 ~ 64岁和65 ~ 75岁EGD患者出血率分别为0.0059%和0.0110% (P = 0.042)， CS患者出血率分别为0.0061%和0.0108% （P = 0.264）。活检比较CS和EGD的出血风险显著（调整优势比[aOR] 95%可信区间[CI] 2.75 [1.15-6.21]; P = 0.017）和抗血栓治疗（aOR 12.48; 95% CI 1.80-247.14; P = 0.026）。50 ~ 64岁男性（11.76 [1.85 ~ 222.65],P = 0.025）穿孔发生率显著高于男性（aOR 9.58; 95% CI 2.17 ~ 66.10; P = 0.006）。结论：与EGD相比，CS有较高的穿孔率，但无出血率。CS的并发症发生率无年龄差异。

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来源期刊

Endoscopy International Open GASTROENTEROLOGY & HEPATOLOGY-

自引率

3.80%

发文量

270