Gastrointestinal and non-gastrointestinal complication rates associated with diagnostic esophagogastroduodenoscopy under sedation

• Published in: Medicine (Baltimore) Vol. 101; no. 19; p. e29266
• Main Authors: Jang, Ji Min, Park, Su Bee, Yoon, Jin Young, Kwak, Min Seob, Cha, Jae Myung
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 13.05.2022; Wolters Kluwer
• Subjects: Aged; Conscious Sedation - adverse effects; Endoscopy, Digestive System - adverse effects; Humans; Hypnotics and Sedatives - adverse effects; Midazolam - adverse effects; Myocardial Infarction - diagnosis; Myocardial Infarction - epidemiology; Observational Study; Propofol - adverse effects; Retrospective Studies
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000029266

Esophagogastroduodenoscopy (EGD) under sedation may result in gastrointestinal (GI) and non-GI complications. However, no previous studies have reported 30-day GI and non-GI complications after diagnostic EGD under sedation.We conducted a retrospective, observational study of 30-day GI and non-GI complication rates after outpatient diagnostic EGD under sedation in subjects ≥18 years between January 2012 and December 2017 based on a common data model database. Thirty-day complication rates were compared with EGD under sedation or not, type of sedation drugs (midazolam only vs midazolam/propofol) and age groups (18-64 year vs ≥65 year) for GI (bleeding and perforation) and non-GI complications (pneumonia, acute myocardial infarction, congestive heart failure and cerebral stroke).In total, 39,910 were performed with sedation (midazolam only, n = 16,033 and midazolam/propofol, n = 23,864) and 22,894 were performed without sedation. Elderly patients significantly favored EGD without sedation (P < .01). GI and non-GI complication rates were similar between EGD under sedation and without sedation (all P > .1) except for acute myocardial infarction rate, which was significantly higher in EGD without sedation than EGD under sedation (1.7/10,000 vs 0.3/10,000 persons, P = .043). All GI and non-GI complications were also similar between the midazolam/propofol and midazolam only groups as well as between young and old patients (all P > .1).Outpatient diagnostic EGD under sedation has an excellent safety profile. In addition, it can be safely performed with midazolam only or midazolam/propofol and in young and old patients.