인구기반 표준 코호트를 이용한 대장 내시경 후 천공 발생: 후향적, 환자-대조군 연구
Complications Following Colonoscopy in a Nationwide Standard Cohort: A Retrospective Case-control Study
김지우, 김수영, 최정혜, 김현수, 이정국, 김윤태, 박근우, 강대룡,
소속 상세정보
김지우 ( Kim Ji-Woo )
연세대학교 원주의과대학 의학과
김수영 ( Kim Su-Young )
연세대학교 원주의과대학 내과학교실
최정혜 ( Choi Jung-Hye )
연세대학교 원주의과대학 내과학교실
김현수 ( Kim Hyun-Soo )
연세대학교 원주의과대학 내과학교실
이정국 ( Lee Jung-Kuk )
연세대학교 원주의과대학 생의학데이터과학센터
김윤태 ( Kim Yun-Tae )
연세대학교 원주의과대학 생의학데이터과학센터
박근우 ( Park Geun-U )
연세대학교 의과대학 의학통계학교실
강대룡 ( Kang Dae-Ryong )
연세대학교 원주의과대학 생의학데이터과학센터
Abstract
Background/Aims: Despite the many reports of colonoscopy complications worldwide, few studies have been performed at the population level in Korea. In this study, a population-based study was performed to evaluate the incidence of post-colonoscopy perforations compared to a control group.
Methods: Between January 2011 and December 2011, data for all cases (age over 45) who underwent a colonoscopy were collected from National Health Insurance Service using a random sampling method. The clinical characteristics and perforation incidence (within 30 days after the colonoscopy) of cases were identified, and cases were then compared with controls who had not undergone a colonoscopy.
Results: Among 1,380,000 subjects, 31,177 cases and 62,354 controls were identified. Perforation occurred in 14 patients (0.04%) in the case group and one patient (<0.01%) in the control group (RR, 28.0; 95% CI 3.7?212.9, p<0.001). Subgroup analysis was followed according to the endoscopic procedure, gender and age. In subgroup analysis, colonoscopy-associated perforations occurred more in the therapeutic procedure (RR, 26; 95% CI 1.46?461.46), male (RR, 50; 95% CI 2.96?844.41), and age of 45?60 years (RR, 30; 95% CI 1.71?525.23).
Conclusions: A colonoscopy procedure is related to an increased risk of perforation at the population level. In addition, the therapeutic procedure, male, and age of 45-60 years appeared to be associated with an increased risk of perforation.
키워드
Colonoscopy; Complications; Intestinal perforation
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