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Korean J Gastroenterol  <  Volume 73(3); 2019 <  Articles

Korean J Gastroenterol 2019; 73(3): 152-158  https://doi.org/10.4166/kjg.2019.73.3.152
Complications Following Colonoscopy in a Nationwide Standard Cohort: A Retrospective Case-control Study
Ji Woo Kim1, Su Young Kim2, Jung Hye Choi2, Hyun-Soo Kim2 , Jung Kuk Lee3, Yun Tae Kim3, Geunu Park4 and Dae Ryong Kang3
Department of Medicine, Yonsei University Wonju College of Medicine1; Department of Internal Medicine, Yonsei University Wonju College of Medicine2; Center of Biomedical Data Science, Yonsei University Wonju College of Medicine3, Wonju; Department of Biostatistics, Yonsei University4, Seoul, Korea
Correspondence to: Hyun-Soo Kim, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea. Tel: +82-33-741-1229, Fax: +82-33-741-1228, E-mail: hyskim@yonsei.ac.kr, ORCID: https://orcid.org/0000-0001-7190-0362
Received: December 20, 2018; Revised: January 15, 2019; Accepted: February 2, 2019; Published online: March 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
Keywords: Colonoscopy; Complications; Intestinal perforation

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