Teoh et al identified risk factors for a patient dying following a colonoscopic perforation. The authors are from the Chinese University and multiple hospitals in Hong Kong.
Major risk factors on multivariate analysis (odds ratio 8 to 12):
(1) ASA classification 3, 4 or 5 (on presentation for the perforation)
(2) antiplatelet therapy
Additional risk factors (higher p value):
(1) moderate to marked fecal contamination
(2) time to presentation <= 48 hours
(3) fair to poor bowel preparation
where:
• Antiplatelet therapy was being taken for cardiovascular or cerebrovascular disease.
A patient at significant risk for mortality should be treated aggressively.
To read more or access our algorithms and calculators, please log in or register.
