Direct Costs of Bleeding and Perforation Complications from Colonoscopy
Bibliographic record
Abstract
Purpose: Screening for colorectal cancer is recommended in Canada for adults 50–74 years of age. Colonoscopy, the most sensitive screening test, is central to any screening strategy. It can be used for either the inital screening examination or for follow-up of a positive non-colonoscopy screening test. However, colonoscopy exposes patients to risk including bleeding, perforation, and death. Population-based estimates of the risks and costs of serious colonoscopy complications in usual practice are not well known. The purpose of this study was to determine the cost of bleeding and perforation complications resulting from colonoscopy in the Calgary Health Region. Methods: From Calgary Health Region administrative datasets, 823 patients who were admitted to an acute care hospital within 30 days of an outpatient colonoscopy from January 2002 to December 2003 were identified. Of these, chart reviews were performed on 133 patients, including all those whose discharge record included an ICD-10 diagnostic code related to bleeding or perforation (N = 53) and a random selection of patients without these codes (n = 80). Selected diagnostic codes included those for a procedural-related complication (T810, T812) and those for bleeding or perforation not due to a procedure complication (i.e. K922 “gastrointestinal hemorrhage”). Only complications resulting from colonoscopy confirmed on chart review were included in the analysis. Inpatient direct health care costs were obtained. Results: All colonoscopies were performed by gastroenterologists or colorectal surgeons. A total of 14 bleeding and 9 perforation complications were identified. The hospitalization costs are shown in the Table. The average hospital length of stay was 4 days (range: 1–24) for bleeding and 22 days (range: 3–36) for perforation.Table: Hospitalization Costs For Colonoscopy ComplicationsConclusions: Although hospitalization for bleeding and perforation resulting from colonoscopy is uncommon, the cost of these complications is high. These data need to be considered when evaluating the overall cost of screening for colorectal cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".