A Retrospective Chart Review Investigating the Use of Colonoscopy in the Elderly

Purpose: Currently, there are no guidelines regarding colonoscopy in the elderly population, excluding cancer screening. There is conflicting data regarding the use of colonoscopy in patients over the age of 80. There exists a significant population in the elderly undergoing colonoscopy for screening, fecal occult blood positive results, hematochezia, and change in bowel habits. Methods: A retrospective chart review from 11/01/04 to 10/13/06 was performed on all patients who underwent a colonoscopy at a community hospital. Patient age, sex, indication for colonoscopy, adverse events during the procedure, findings during colonoscopy, and results of biopsy or polypectomy, if completed, were all documented. A colonoscopy performed for a screening exam, fecal occult blood positive, hematochezia, and change in bowel habits were included. Results: A total of 173 colonoscopic examinations took place that met the strict inclusion/exclusion criteria of the study. Four adverse events occurred in our study population. Two colonic perforations and two events of aspiration occurred. Additionally, seven patients had incomplete exams due to a poor colon preparation. Of the 173 examinations, only 1 examination revealed a malignant process. This malignancy was found in a patient with change in bowel movements. No malignant lesions were found in the hematochezia and screening population of the study. Conclusion: Colonoscopy in patients over the age of 80 demonstrated minimal diagnostic yield. Colonoscopy itself does carry risk of adverse events that must be considered, especially when diagnostic yield is extremely minimal. Further research is necessary to establish guidelinesTable: Colonoscopy in the Elderly.