Modifications in endoscopic practice for the elderly

Dayna S. Early; Ruben D. Acosta; Vinay Chandrasekhara; Krishnavel V. Chathadi; G. Anton Decker; John A. Evans; Robert D. Fanelli; Deborah A. Fisher; Kimberly Q. Foley; Lisa Fonkalsrud; Joo Ha Hwang; Terry Jue; Mouen A. Khashab; Jenifer R. Lightdale; V. Raman Muthusamy; Shabana F. Pasha; John R. Saltzman; Ravi Sharaf; Amandep K. Shergill; Brooks D. Cash

doi:10.1016/j.gie.2013.04.161

Modifications in endoscopic practice for the elderly

Dayna S. Early, Ruben D. Acosta, Vinay Chandrasekhara, Krishnavel V. Chathadi, G. Anton Decker, John A. Evans, Robert D. Fanelli, Deborah A. Fisher, Kimberly Q. Foley, Lisa Fonkalsrud, Joo Ha Hwang, Terry Jue, Mouen A. Khashab, Jenifer R. Lightdale, V. Raman Muthusamy, Shabana F. Pasha, John R. Saltzman, Ravi Sharaf, Amandep K. Shergill, Brooks D. Cash

Research output: Contribution to journal › Article › peer-review

36 Scopus citations

Abstract

We recommend that with optimal periprocedure evaluation and care, diagnostic and therapeutic endoscopic interventions can be safely performed in elderly patients. We recommend that electrolyte-balanced polyethylene glycol-based colonoscopy preparations be used in elderly individuals to avoid potentially harmful fluid and electrolyte shifts. We suggest using split-dosage cathartic bowel preparations in the elderly for colonoscopy preparation. We recommend evaluating the patient's baseline functional status, cognitive ability, and capacity to understand the anticipated endoscopic procedure as part of the preprocedure assessment in the elderly. We recommend standard monitoring procedures in the elderly during moderate sedation with heightened awareness of this population's increased response to sedatives. We recommend that lower initial doses of sedatives than standard adult dosing should be considered in the elderly and that titration should be more gradual to allow assessment of the full dose effect at each dose level. We suggest that practitioners exercise additional caution when performing colonoscopy in elderly patients because this procedure may confer a higher risk of adverse events. We recommend that colonoscopic screening and surveillance for colorectal cancer in patients of advanced age be individualized based on general health and comorbid medical illnesses.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	Gastrointestinal endoscopy
Volume	78
Issue number	1
DOIs	https://doi.org/10.1016/j.gie.2013.04.161
State	Published - Jul 2013

Keywords

DBE
OR
double-balloon endoscopy
odds ratio

Access to Document

10.1016/j.gie.2013.04.161

Cite this

Early, D. S., Acosta, R. D., Chandrasekhara, V., Chathadi, K. V., Decker, G. A., Evans, J. A., Fanelli, R. D., Fisher, D. A., Foley, K. Q., Fonkalsrud, L., Hwang, J. H., Jue, T., Khashab, M. A., Lightdale, J. R., Muthusamy, V. R., Pasha, S. F., Saltzman, J. R., Sharaf, R., Shergill, A. K., & Cash, B. D. (2013). Modifications in endoscopic practice for the elderly. Gastrointestinal endoscopy, 78(1), 1-7. https://doi.org/10.1016/j.gie.2013.04.161

@article{c5f3ece7f8974bcf821b2da1ee2ef520,

title = "Modifications in endoscopic practice for the elderly",

abstract = "We recommend that with optimal periprocedure evaluation and care, diagnostic and therapeutic endoscopic interventions can be safely performed in elderly patients. We recommend that electrolyte-balanced polyethylene glycol-based colonoscopy preparations be used in elderly individuals to avoid potentially harmful fluid and electrolyte shifts. We suggest using split-dosage cathartic bowel preparations in the elderly for colonoscopy preparation. We recommend evaluating the patient's baseline functional status, cognitive ability, and capacity to understand the anticipated endoscopic procedure as part of the preprocedure assessment in the elderly. We recommend standard monitoring procedures in the elderly during moderate sedation with heightened awareness of this population's increased response to sedatives. We recommend that lower initial doses of sedatives than standard adult dosing should be considered in the elderly and that titration should be more gradual to allow assessment of the full dose effect at each dose level. We suggest that practitioners exercise additional caution when performing colonoscopy in elderly patients because this procedure may confer a higher risk of adverse events. We recommend that colonoscopic screening and surveillance for colorectal cancer in patients of advanced age be individualized based on general health and comorbid medical illnesses.",

keywords = "DBE, OR, double-balloon endoscopy, odds ratio",

author = "Early, {Dayna S.} and Acosta, {Ruben D.} and Vinay Chandrasekhara and Chathadi, {Krishnavel V.} and Decker, {G. Anton} and Evans, {John A.} and Fanelli, {Robert D.} and Fisher, {Deborah A.} and Foley, {Kimberly Q.} and Lisa Fonkalsrud and Hwang, {Joo Ha} and Terry Jue and Khashab, {Mouen A.} and Lightdale, {Jenifer R.} and Muthusamy, {V. Raman} and Pasha, {Shabana F.} and Saltzman, {John R.} and Ravi Sharaf and Shergill, {Amandep K.} and Cash, {Brooks D.}",

year = "2013",

month = jul,

doi = "10.1016/j.gie.2013.04.161",

language = "English",

volume = "78",

pages = "1--7",

journal = "Gastrointestinal endoscopy",

issn = "0016-5107",

number = "1",

}

Early, DS, Acosta, RD, Chandrasekhara, V, Chathadi, KV, Decker, GA, Evans, JA, Fanelli, RD, Fisher, DA, Foley, KQ, Fonkalsrud, L, Hwang, JH, Jue, T, Khashab, MA, Lightdale, JR, Muthusamy, VR, Pasha, SF, Saltzman, JR, Sharaf, R, Shergill, AK & Cash, BD 2013, 'Modifications in endoscopic practice for the elderly', Gastrointestinal endoscopy, vol. 78, no. 1, pp. 1-7. https://doi.org/10.1016/j.gie.2013.04.161

TY - JOUR

T1 - Modifications in endoscopic practice for the elderly

AU - Early, Dayna S.

AU - Acosta, Ruben D.

AU - Chandrasekhara, Vinay

AU - Chathadi, Krishnavel V.

AU - Decker, G. Anton

AU - Evans, John A.

AU - Fanelli, Robert D.

AU - Fisher, Deborah A.

AU - Foley, Kimberly Q.

AU - Fonkalsrud, Lisa

AU - Hwang, Joo Ha

AU - Jue, Terry

AU - Khashab, Mouen A.

AU - Lightdale, Jenifer R.

AU - Muthusamy, V. Raman

AU - Pasha, Shabana F.

AU - Saltzman, John R.

AU - Sharaf, Ravi

AU - Shergill, Amandep K.

AU - Cash, Brooks D.

PY - 2013/7

Y1 - 2013/7

N2 - We recommend that with optimal periprocedure evaluation and care, diagnostic and therapeutic endoscopic interventions can be safely performed in elderly patients. We recommend that electrolyte-balanced polyethylene glycol-based colonoscopy preparations be used in elderly individuals to avoid potentially harmful fluid and electrolyte shifts. We suggest using split-dosage cathartic bowel preparations in the elderly for colonoscopy preparation. We recommend evaluating the patient's baseline functional status, cognitive ability, and capacity to understand the anticipated endoscopic procedure as part of the preprocedure assessment in the elderly. We recommend standard monitoring procedures in the elderly during moderate sedation with heightened awareness of this population's increased response to sedatives. We recommend that lower initial doses of sedatives than standard adult dosing should be considered in the elderly and that titration should be more gradual to allow assessment of the full dose effect at each dose level. We suggest that practitioners exercise additional caution when performing colonoscopy in elderly patients because this procedure may confer a higher risk of adverse events. We recommend that colonoscopic screening and surveillance for colorectal cancer in patients of advanced age be individualized based on general health and comorbid medical illnesses.

AB - We recommend that with optimal periprocedure evaluation and care, diagnostic and therapeutic endoscopic interventions can be safely performed in elderly patients. We recommend that electrolyte-balanced polyethylene glycol-based colonoscopy preparations be used in elderly individuals to avoid potentially harmful fluid and electrolyte shifts. We suggest using split-dosage cathartic bowel preparations in the elderly for colonoscopy preparation. We recommend evaluating the patient's baseline functional status, cognitive ability, and capacity to understand the anticipated endoscopic procedure as part of the preprocedure assessment in the elderly. We recommend standard monitoring procedures in the elderly during moderate sedation with heightened awareness of this population's increased response to sedatives. We recommend that lower initial doses of sedatives than standard adult dosing should be considered in the elderly and that titration should be more gradual to allow assessment of the full dose effect at each dose level. We suggest that practitioners exercise additional caution when performing colonoscopy in elderly patients because this procedure may confer a higher risk of adverse events. We recommend that colonoscopic screening and surveillance for colorectal cancer in patients of advanced age be individualized based on general health and comorbid medical illnesses.

KW - DBE

KW - OR

KW - double-balloon endoscopy

KW - odds ratio

UR - http://www.scopus.com/inward/record.url?scp=84879793875&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2013.04.161

DO - 10.1016/j.gie.2013.04.161

M3 - Article

C2 - 23664042

AN - SCOPUS:84879793875

SN - 0016-5107

VL - 78

SP - 1

EP - 7

JO - Gastrointestinal endoscopy

JF - Gastrointestinal endoscopy

IS - 1

ER -

Modifications in endoscopic practice for the elderly

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this