Open-access colonoscopy: Outcomes of referrals from the emergency department

Abstract

Aim The study investigated the diagnostic outcome of colonoscopy referrals from the emergency department (ED) via an open-access system. Method A retrospective cohort study over twoyears was performed on all patients under 65years referred for open-access colonoscopy by the ED in a hospital with an annual ED attendance of 140000. Patient characteristics and presenting symptoms were retrieved. Waiting times from presentation to colonoscopy were recorded. Results Over a 2-year period, 266 patients were referred, of whom 37 defaulted, leaving 229 patients who had a colonoscopy. The mean age was 48.3±11.3 (SD) and the female/male ratio was 229/125. The most frequent presenting symptoms included: rectal bleeding (n=142, 62%), change of bowel habit (n=47, 20.5%) and abdominal pain (n=40, 17.5%). The median waiting time from presentation to colonoscopy was 17 (range 1-69) days. A positive colonoscopic finding was recorded in 45.4%, including colorectal cancer in 12 (5.2%). Conclusion The rate of a positive diagnoses from the ED-based colonoscopy referral service was comparable to that of the general Hong Kong population. This approach may help to reduce the waiting time for colonoscopy in a specialist colorectal clinic. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.