Title : Utility value of colonoscopy in octonanogenarians
Abstract:
Aim: To evaluate the rationale and effectiveness of colonoscopy in patients aged over 80 years during a one-year period at Southport Hospital, which serves a predominantly geriatric population. Current protocol-driven diagnostic pathways frequently result in direct triaging to endoscopy, potentially bypassing comprehensive assessment of biological age, procedural feasibility, and overall risk–benefit balance.
Methods: A retrospective audit was conducted involving 105 patients aged over 80 who underwent colonoscopy between January and December 2021. Data was collected using a structured audit proforma, encompassing pre-, intra-, and post-procedural variables, and were obtained from hospital endoscopy and clinical records.
Results: Pre-procedural demographics identified anaemia (31%) and change in bowel habit (26%) as the most common indications. The overall completion rate was 73%. Diagnostic findings included diverticulosis (52%), polyps (9%), colitis (3%), and malignancy (15%). Factors contributing to incomplete procedures and reduced diagnostic yield included patient discomfort, colonic angulation, inadequate bowel preparation, as well as the impact of polypharmacy and multiple comorbidities.
Conclusion: The findings suggest that a more selective, targeted approach to endoscopy in this age group may be preferable to its routine use as a first-line investigation, in order to optimise diagnostic yield and procedural efficacy.
