877 Utility Value of Colonoscopy in the Over 80's

Abstract

Abstract Aim To audit the rationale and efficacy of colonoscopy in the over 80’s over a year period at Southport hospital which caters to a geriatrically skewed population. Currently protocol driven diagnostic pathways often lead to direct triaging of patients to endoscopy preventing assessment of biological age of patient, practicalities of the procedure and risk-benefit ratio. Method A retrospective audit with data in 105 patients over the age of 80 who underwent colonoscopy in 2021 January – December 2021 was collated. An audit proforma looking at pre-, during- and post -colonoscopy data was evaluated using the hospital endoscopy records and clinical records. Results Pre-colonoscopy demographics showed that anaemia (31%) and change in bowel habit (26%) were the most common indications for colonoscopy. Completion rates, diagnostic yield and complication rates were evaluated. Completion rate was 73%. Positive findings were diverticulosis (52%), polyps (9%), colitis (3%) and malignancy in 15%. Mitigating factors for non-completion and poor efficacy were discomfort, angulation, poor bowel prep as well as incriminating polypharmacy and comorbidity. Conclusions Based on the audit findings targeted endoscopy in this age group is a better management rather than its usage as first line investigation to achieve maximum efficacy.