The impact of anesthesia providers on major morbidity following screening colonoscopies

David Lubarsky, Jason R. Guercio, John W. Hanna, Maria T Abreu, Qianli Ma, Claudia Uribe, David Birnbach, David Sinclair, Keith A Candiotti

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and aims: Few studies evaluate the impact of anesthesia providers during procedures, such as colonoscopy, on low-risk patients. The objective of this study was to compare the effect of anesthesia providers on several outcome variables, including major morbidity, following screening colonoscopies. Methods: A propensity-matched cohort study of 14,006 patients who enrolled with a national insurer offering health maintenance organization (HMO), preferred provider organization (PPO), and Medicare Advantage plans for a screening colonoscopy between July 1, 2005 and June 30, 2007 were studied. Records were evaluated for completion of the colonoscopy, new cancer diagnosis (colon, anal, rectal) within 6 months of the colonoscopy, new primary diagnosis of myocardial infarction (MI), new primary diagnosis of stroke, hospital admission within 7 days of the colonoscopy, and adherence to guidelines for use of anesthesia providers. Results: The presence of an anesthesia provider did not affect major morbidity or the percent of completed exams. Overall morbidity within 7 days was very low. When an anesthesia provider was present, a nonsignificant trend toward greater cancer detection within 6 months of the procedure was observed. Adherence to national guidelines regarding the use of anesthesia providers for low-risk patients was poor. Conclusion: A difference in outcome associated with the presence or absence of an anesthesia provider during screening colonoscopy in terms of MI, stroke, or hospital admission within 7 days of the procedure was not observed. Adherence to published guidelines for the use of anesthesia providers is low. The incidence of completed exams was unaffected by the presence of an anesthesia provider. However, a nonstatistically significant trend toward increased cancer detection requires further study.

Original languageEnglish (US)
Pages (from-to)255-270
Number of pages16
JournalJournal of Multidisciplinary Healthcare
Volume8
DOIs
StatePublished - May 28 2015

Fingerprint

Colonoscopy
Anesthesia
Morbidity
Preferred Provider Organizations
Medicare Part C
Stroke
Myocardial Infarction
Guidelines
Guideline Adherence
Insurance Carriers
Health Maintenance Organizations
Colonic Neoplasms
Neoplasms
Cohort Studies
Incidence

Keywords

  • Anesthesiology
  • Complications
  • Endoscopy
  • Myocardial infarction
  • Safety
  • Stroke

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

Cite this

The impact of anesthesia providers on major morbidity following screening colonoscopies. / Lubarsky, David; Guercio, Jason R.; Hanna, John W.; Abreu, Maria T; Ma, Qianli; Uribe, Claudia; Birnbach, David; Sinclair, David; Candiotti, Keith A.

In: Journal of Multidisciplinary Healthcare, Vol. 8, 28.05.2015, p. 255-270.

Research output: Contribution to journalArticle

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