Identifying and reporting risk factors for adverse events in endoscopy. Part I: Cardiopulmonary events

Our goal was to identify or develop a relatively small data set that would be useful in predicting the risk of endoscopic procedures. This review shows that this is not an easy task because there are a wide range of factors and a variety of risks. Risk assessment may also be complex when more than 1 risk factor is present because the way in which different factors interact is variable. Risk factors for cardiopulmonary AEs seem different from those for noncardiopulmonary AEs. However, factors that predict cardiopulmonary events likely also influence the outcome (morbidity and mortality) of noncardiopulmonary events (eg, pancreatitis or perforation) when they occur, even if they do not increase the frequency of those AEs. For cardiopulmonary events, it seems that documentation should include age, inpatient versus outpatient status (perhaps also clarify for inpatients where [endoscopy suite vs other] and when [routine hours vs off-hours, elective vs urgent/emergent] the procedure is performed), trainee involvement, the type of sedation or anesthesia, supplemental oxygen use, and major comorbidities (especially cardiopulmonary, including severe COPD and sleep apnea).