The risk of suffering complications from outpatient colonoscopy is roughly the same whether the procedure is performed in a hospital or an ambulatory surgery center, according to a study presented at Digestive Disease Week 2011.

The one big difference between the two settings? Cost.

"The implication of our research is that, if these adverse events are equal between both settings, with lower costs-per-case associated with outpatient colonoscopy when performed at these ambulatory surgery centers, there might be a cost saving for Medicare," said M. Fuad Azrak, MD, gastrointestinal fellow at Emory University, as he presented his findings at the Chicago DDW meeting.

Taking a random sample of 174,000 Medicare patients who had outpatient colonoscopies from 1992 to 2007, Dr. Azrak and colleagues evaluated their rate of emergency room visits or hospitalizations for complications such as bowel perforation, heart attack or abnormal heart rhythms within 30 days of undergoing the procedure.

The difference in the rate of these complications per 100 patients, when adjusted for a variety of factors, was not statistically significant between those screened in hospitals and those screened in ASCs, leading Dr. Azrak to conclude that the safety outcomes of outpatient colonoscopy are roughly equivalent in both settings.

However, he could not say conclusively whether it was better to have the procedure done in an ASC vs. a hospital based on his findings alone, according to a DDW press release, since he only evaluated complication rates, not other quality indicators such as polyp-detection rates.

Irene Tsikitas