Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy

J. J. Vargo, J. L. Holub, Douglas Orrick Faigel, D. A. Lieberman, G. M. Eisen

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background: Propofol-mediated sedation for endoscopy is popular because of its rapid onset and recovery profile. Aim: To examine procedure-specific occurrence and risk factors for cardiopulmonary events during propofol-mediated upper endoscopy (EGD) and colonoscopy. Design: A cohort study using the Clinical Outcomes Research Initiative database was used to determine the frequency of cardiopulmonary events. Clinical Outcomes Research Initiative consisted of 69 practice sites comprising 593 US endoscopists. Multivariate logistic regression analysis used variables, such as age, ASA classification and propofol administration by monitored anaesthesia care or gastroenterologist-administered propofol to determine the risk of cardiopulmonary events. Results: The overall cardiopulmonary event rate for 5928 EGDs and 11 683 colonoscopies was 11.7/1000 cases. For colonoscopy, ascending ASA classification was associated with an increased risk. Monitored anaesthesia care was associated with a decreased adjusted relative risk (0.5, 95% CI: 0.36-0.72). ASA I and II patients receiving monitored anaesthesia care for EGD exhibited a significantly lower relative risk (ARR 0.29, 95% CI: 0.14-0.64). For subjects with ASA class III or greater, there was no difference in the risk between monitored anaesthesia care and gastroenterologist-administered propofol. Conclusions: There are procedure-specific risk factors for cardiopulmonary events during propofol-mediated EGD and colonoscopy. These should be taken into account during future prospective comparative trials.

Original languageEnglish (US)
Pages (from-to)955-963
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume24
Issue number6
DOIs
StatePublished - Sep 2006
Externally publishedYes

Fingerprint

Propofol
Colonoscopy
Endoscopy
Anesthesia
Outcome Assessment (Health Care)
Cohort Studies
Logistic Models
Regression Analysis
Databases

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy. / Vargo, J. J.; Holub, J. L.; Faigel, Douglas Orrick; Lieberman, D. A.; Eisen, G. M.

In: Alimentary Pharmacology and Therapeutics, Vol. 24, No. 6, 09.2006, p. 955-963.

Research output: Contribution to journalArticle

@article{a40a437c54b84798bddddaadc496e363,
title = "Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy",
abstract = "Background: Propofol-mediated sedation for endoscopy is popular because of its rapid onset and recovery profile. Aim: To examine procedure-specific occurrence and risk factors for cardiopulmonary events during propofol-mediated upper endoscopy (EGD) and colonoscopy. Design: A cohort study using the Clinical Outcomes Research Initiative database was used to determine the frequency of cardiopulmonary events. Clinical Outcomes Research Initiative consisted of 69 practice sites comprising 593 US endoscopists. Multivariate logistic regression analysis used variables, such as age, ASA classification and propofol administration by monitored anaesthesia care or gastroenterologist-administered propofol to determine the risk of cardiopulmonary events. Results: The overall cardiopulmonary event rate for 5928 EGDs and 11 683 colonoscopies was 11.7/1000 cases. For colonoscopy, ascending ASA classification was associated with an increased risk. Monitored anaesthesia care was associated with a decreased adjusted relative risk (0.5, 95{\%} CI: 0.36-0.72). ASA I and II patients receiving monitored anaesthesia care for EGD exhibited a significantly lower relative risk (ARR 0.29, 95{\%} CI: 0.14-0.64). For subjects with ASA class III or greater, there was no difference in the risk between monitored anaesthesia care and gastroenterologist-administered propofol. Conclusions: There are procedure-specific risk factors for cardiopulmonary events during propofol-mediated EGD and colonoscopy. These should be taken into account during future prospective comparative trials.",
author = "Vargo, {J. J.} and Holub, {J. L.} and Faigel, {Douglas Orrick} and Lieberman, {D. A.} and Eisen, {G. M.}",
year = "2006",
month = "9",
doi = "10.1111/j.1365-2036.2006.03099.x",
language = "English (US)",
volume = "24",
pages = "955--963",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Risk factors for cardiopulmonary events during propofol-mediated upper endoscopy and colonoscopy

AU - Vargo, J. J.

AU - Holub, J. L.

AU - Faigel, Douglas Orrick

AU - Lieberman, D. A.

AU - Eisen, G. M.

PY - 2006/9

Y1 - 2006/9

N2 - Background: Propofol-mediated sedation for endoscopy is popular because of its rapid onset and recovery profile. Aim: To examine procedure-specific occurrence and risk factors for cardiopulmonary events during propofol-mediated upper endoscopy (EGD) and colonoscopy. Design: A cohort study using the Clinical Outcomes Research Initiative database was used to determine the frequency of cardiopulmonary events. Clinical Outcomes Research Initiative consisted of 69 practice sites comprising 593 US endoscopists. Multivariate logistic regression analysis used variables, such as age, ASA classification and propofol administration by monitored anaesthesia care or gastroenterologist-administered propofol to determine the risk of cardiopulmonary events. Results: The overall cardiopulmonary event rate for 5928 EGDs and 11 683 colonoscopies was 11.7/1000 cases. For colonoscopy, ascending ASA classification was associated with an increased risk. Monitored anaesthesia care was associated with a decreased adjusted relative risk (0.5, 95% CI: 0.36-0.72). ASA I and II patients receiving monitored anaesthesia care for EGD exhibited a significantly lower relative risk (ARR 0.29, 95% CI: 0.14-0.64). For subjects with ASA class III or greater, there was no difference in the risk between monitored anaesthesia care and gastroenterologist-administered propofol. Conclusions: There are procedure-specific risk factors for cardiopulmonary events during propofol-mediated EGD and colonoscopy. These should be taken into account during future prospective comparative trials.

AB - Background: Propofol-mediated sedation for endoscopy is popular because of its rapid onset and recovery profile. Aim: To examine procedure-specific occurrence and risk factors for cardiopulmonary events during propofol-mediated upper endoscopy (EGD) and colonoscopy. Design: A cohort study using the Clinical Outcomes Research Initiative database was used to determine the frequency of cardiopulmonary events. Clinical Outcomes Research Initiative consisted of 69 practice sites comprising 593 US endoscopists. Multivariate logistic regression analysis used variables, such as age, ASA classification and propofol administration by monitored anaesthesia care or gastroenterologist-administered propofol to determine the risk of cardiopulmonary events. Results: The overall cardiopulmonary event rate for 5928 EGDs and 11 683 colonoscopies was 11.7/1000 cases. For colonoscopy, ascending ASA classification was associated with an increased risk. Monitored anaesthesia care was associated with a decreased adjusted relative risk (0.5, 95% CI: 0.36-0.72). ASA I and II patients receiving monitored anaesthesia care for EGD exhibited a significantly lower relative risk (ARR 0.29, 95% CI: 0.14-0.64). For subjects with ASA class III or greater, there was no difference in the risk between monitored anaesthesia care and gastroenterologist-administered propofol. Conclusions: There are procedure-specific risk factors for cardiopulmonary events during propofol-mediated EGD and colonoscopy. These should be taken into account during future prospective comparative trials.

UR - http://www.scopus.com/inward/record.url?scp=33748310553&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748310553&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2006.03099.x

DO - 10.1111/j.1365-2036.2006.03099.x

M3 - Article

C2 - 16948807

AN - SCOPUS:33748310553

VL - 24

SP - 955

EP - 963

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 6

ER -