Colonoscopy can be performed safely in carefully selected patients in the very elderly age group above 90 years of age, according to Australian data.
A retrospective study of 60 patients, 90-100 years of age, who underwent colonoscopies at two Sydney hospitals, has shown no post-colonoscopy complications or readmissions and no 30-day morbidity or mortality associated with the procedure.
The study, published in the ANZ Journal of Surgery [link here], included both public and private patients undergoing colonoscopy between January 2018 and November 2022.
Most patients (70%) were American Society of Anaesthesiologists (ASA) classification III with about 12% having poorer physical status (ASA IV) and the rest having better health (ASA II) with one patient regarded as having normal good health (ASA I).
Reasons for the emergency or elective colonoscopies included rectal bleeding (40%), anaemia (22%), polyp surveillance (10%), a positive FOBT (8%) or cancer surveillance (7%).
Significant colonoscopy findings included rectal or caecal cancer (seven patients or 11.7%), multiple >5 polyps (six patients) and angioectasia (two patients).
“Most patients were either discharged on the same day of colonoscopy or observed overnight and discharged the subsequent day,” the study said.
“Prolonged length of stay in the hospital (more than 1 night) after the colonoscopy was due to reasons such as: stayed in hospital to await definitive surgery, awaiting rehab bed, medical management of other co-morbidities unrelated to colonoscopy and discharge planning.”
“There were no complications after the colonoscopy. There were no 30-day readmission, or 30-day mortality/morbidity related to the colonoscopy.”