Su1292 Lower Adenoma Detection Rates in Afternoon Colonoscopies May Be Due to Rushing and Not Fatigue

Abstract

( 5, 5-10, 11-15, 16-20, 20 yrs), average endoscopic procedures/week (10-20, 21-30, 31-40, 40). Reasons for holding or continuing and time duration these agents weld held prior to and after procedures. Endoscopists experience of any complications secondary to holding or continuing different anti-platelet agents was also queried. Questions on holding or continuing specific anti-platelets agents in-combinations prior to low or high risk endoscopic procedures. Results: 400 study questionnaires were distributed and 136 responses received (response rate: 34%). The majority (82%) were community GIs, 68% in 4160 yrs age group, 76% 10 yrs of experience, 87% performed 30 procedures/week. GIs experiencing acute ischemic event when held: aspirin 11% (12/110); dipyridamole 6% (6/105) and clopidogrel 30% (34/114). GIs witnessed significant GI bleeding when continued: aspirin 38% (43/112); dipyridamole 23% (24/103) and clopidogrel 63% (71/112). GIs decision to continue/hold anti-platelet agents during endoscopy was based on patients factors (37%, 50/136), their own experience (15%, 21/136), and only 47% (64/136) followed ASGE guidelines for certain high risk procedures. 17% of all respondents would stop all anti-platelet agents for any endoscopic procedure; aspirin or NSAIDS held for 3-5 days (58%), dipyridamole or clopidogrel for 5-7 days (56%) and following endoscopy restarted within 3-5 days with polypectomy (73%), esophageal dilation (70%), ERCP with sphincterotomy (87%) and EUS with FNA (84%). Endoscopists who performed endoscopic procedures while patients were on single or multiple antiplatelet agents are shown in the Table. Conclusions: Results from this survey highlight the wide variation in practice patterns for managing various antiplatelet agents’ during endoscopic procedures among gastroenterologists despite the availability of guidelines on this topic. More than 15% of the respondents would hold all anti-platelet agents prior to any endoscopic procedures. This highlights the need for better educational tools to assist practicing gastroenterologists on this topic.