TABLE 4.
Odds ratios (95% confidence intervals) from multivariate logistic regression analyses of colonoscopy-related adverse events for various factors, with modeling that recognized clustering of outcomes by endoscopist
| Cumulative GI adverse events | GI bleeding | Colonic perforation | |
|---|---|---|---|
| Cold biopsy forceps | 1.21 (1.01-1.44) | 1.84 (1.47-2.30) | 0.66 (0.50-0.87) |
| Polypectomy by ablation | 3.75 (2.97-4.72) | 6.82 (5.25-8.85) | 1.20 (0.73-1.98) |
| Polypectomy by hot biopsy or bipolar cautery forceps | 5.63 (4.97-6.39) | 10.90 (9.33-12.74) | 1.22 (0.97-1.55) |
| Polypectomy by snares | 7.75 (6.95-8.64) | 15.13 (13.18-17.35) | 1.56 (1.29-1.89) |
| Complex colonoscopy | 8.83 (7.70-0.12) | 16.97 (14.38-20.02) | 1.99 (1.56-2.54) |
| Endoscopist volume <300 | 1.18 (1.07-1.30) | 1.13 (1.02-1.25) | 1.49 (1.23-1.80) |
| ASC | 1.27 (1.16-1.40) | 1.11 (1.01-1.23) | 2.67 (2.21-3.22) |
| Risk score | 1.34 (1.19-1.50) | 1.25 (1.11-1.42) | 1.80 (1.39-2.34) |
| Age 50-64 | 1.13 (0.99-1.28) | 1.08 (0.94-1.25) | 1.38 (1.01-1.87) |
| Age 65-74 | 1.31 (1.12-1.53) | 1.22 (1.03-1.45) | 1.80 (1.24-2.62) |
| Age 75-84 | 1.81 (1.54-2.13) | 1.71 (1.43-2.05) | 2.36 (1.61-3.48) |
| Age >85 | 2.43 (2.00-2.95) | 2.34 (1.90-2.88) | 2.88 (1.75-4.72) |
| Female | 0.74 (0.69-0.79) | 0.65 (0.61-0.70) | 1.33 (1.15-1.55) |
| Hispanic | 1.18 (1.05-1.33) | 1.23 (1.08-1.39) | 0.99 (0.75-1.31) |
| Black or African American | 1.23 (1.07-1.42) | 1.32 (1.13-1.53) | 0.86 (0.60-1.25) |
| Other or unknown race | 0.98 (0.87-1.12) | 1.00 (0.87-1.14) | 0.90 (0.68-1.20) |
| Medicare HMO | 1.08 (0.93-1.26) | 1.04 (0.88-1.24) | 1.34 (0.99-1.82) |
| Medicaid | 1.35 (1.00-1.81) | 1.28 (0.91-1.79) | 1.74 (0.91-3.33) |
| Medicaid HMO | 1.13 (0.68-1.88) | 1.22 (0.74-2.01) | 0.57 (0.08-3.90) |
| Indemnity | 0.90 (0.80-1.00) | 0.90 (0.79-1.03) | 0.88 (0.66-1.16) |
| Commercial HMO | 1.00 (0.88-1.12) | 0.97 (0.86-1.11) | 1.11 (0.84-1.47) |
| Commercial PPO | 0.99 (0.87-1.14) | 0.96 (0.83-1.11) | 1.19 (0.87-1.64) |
| Self pay/charity | 1.25 (0.97-1.62) | 1.28 (0.98-1.68) | 1.00 (0.45-2.28) |
| Other payers | 1.01 (0.81-1.25) | 0.92 (0.71-1.20) | 1.45 (0.91-2.31) |
| 1998 | 1.06 (0.92-1.23) | 1.00 (0.86-1.18) | 1.43 (0.99-2.07) |
| 1999 | 0.88 (0.75-1.02) | 0.84 (0.71-1.00) | 1.08 (0.73-1.59) |
| 2000 | 1.06 (0.92-1.22) | 1.03 (0.86-1.20) | 1.22 (0.86-1.73) |
| 2001 | 0.96 (0.83-1.12) | 0.94 (0.80-1.11) | 1.08 (0.75-1.57) |
| 2002 | 0.91 (0.78-1.05) | 0.86 (0.73-1.01) | 1.20 (0.85-1.71) |
| 2003 | 0.95 (0.82-1.10) | 0.93 (0.79-1.09) | 1.06 (0.75-1.52) |
| 2004 | 0.89 (0.77-1.03) | 0.85 (0.72-0.99) | 1.15 (0.81-1.62) |
ACS, Ambulatory surgery center; HMO, health maintenance organization; PPO, preferred provider organization.