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



• Antiplatelet therapy was being taken for cardiovascular or cerebrovascular disease.


A patient at significant risk for mortality should be treated aggressively.


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