Screening Colonoscopy Adverse Events in Aging Adults: Does Frailty Matter?

Abstract

Screening colonoscopy is beneficial in screening for colorectal cancer, though it is not without risks, which increase with increasing age. The objectives of this prospective feasibility and outcomes study was to assess the effectiveness of the upper-extremity frailty (UEF) test to risk stratify adults ≥ 50 years of age undergoing routine screening colonoscopy. Socio-demographic data, the Charlson Comorbidity Index (CCI), and UEF clinical frailty syndrome classification (nonfrail versus pre-frail/frail) were assessed prior to colonoscopy, and acute colonoscopy outcomes were stratified into three severity categories. Logistic regression and ANOVA/ ANCOVA were employed. 41% of non-frail had one or more complications, versus 70% of pre-frail/frail group. Those in the pre-frail/frail group had nearly three times the number of acute colonoscopy complications (OR 2.84, p = 0.01) when compared to the nonfrail. Chronological age, and comorbidity score (CCI) failed to predict complication outcomes. UEF frailty was useful in predicting acute complications in screening colonoscopy.