Impact of Moderate versus Deep Sedation and Trainee Participation on Adenoma Detection Rate - Analysis of a Veteran Population
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Background/Aims: The adenoma detection rate (ADR) is used as a quality indicator for screening and surveillance colonoscopy. Thestudy aimed to determine if moderate versus deep sedation affects the outcomes of the ADR and other quality metrics in the veteranpopulation. Methods: A retrospective review of colonoscopies performed at Memphis Veterans Affairs Medical Center over a one-year periodwas conducted. A total of 900 colonoscopy reports were reviewed. After exclusion criteria, a total of 229 index, average-risk screeningcolonoscopies were identified. Data were collected to determine the impact of moderate (benzodiazepine plus opioids) versus deep(propofol) sedation on the ADR, polyp detection rate (PDR), and withdrawal time. Results: Among 229 screening colonoscopies, 103 (44.9%) used moderate sedation while 126 (55%) were done under deep sedation. The ADR and PDR were not significantly different between moderate versus deep sedation at 35.9% vs. 37.3% (p=0.82) and 58.2% vs. 48.4% (p=0.13), respectively. Similarly, there was no significant difference in withdrawal time between moderate and deep sedation(13.4 min vs. 14 min, p=0.56) during screening colonoscopies. Conclusions: In veterans undergoing index, average-risk screening colonoscopies, the quality metrics of the ADR, PDR, andwithdrawal time are not influenced by deep sedation compared with moderate sedation.
Abstract
Background/Aims: The adenoma detection rate (ADR) is used as a quality indicator for screening and surveillance colonoscopy. Thestudy aimed to determine if moderate versus deep sedation affects the outcomes of the ADR and other quality metrics in the veteranpopulation. Methods: A retrospective review of colonoscopies performed at Memphis Veterans Affairs Medical Center over a one-year periodwas conducted. A total of 900 colonoscopy reports were reviewed. After exclusion criteria, a total of 229 index, average-risk screeningcolonoscopies were identified. Data were collected to determine the impact of moderate (benzodiazepine plus opioids) versus deep(propofol) sedation on the ADR, polyp detection rate (PDR), and withdrawal time. Results: Among 229 screening colonoscopies, 103 (44.9%) used moderate sedation while 126 (55%) were done under deep sedation. The ADR and PDR were not significantly different between moderate versus deep sedation at 35.9% vs. 37.3% (p=0.82) and 58.2% vs. 48.4% (p=0.13), respectively. Similarly, there was no significant difference in withdrawal time between moderate and deep sedation(13.4 min vs. 14 min, p=0.56) during screening colonoscopies. Conclusions: In veterans undergoing index, average-risk screening colonoscopies, the quality metrics of the ADR, PDR, andwithdrawal time are not influenced by deep sedation compared with moderate sedation.
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