Association between Colonoscopy Sedation Type and Polyp Detection: A Registry-based Cohort Study
Authors' conclusion
Propofol sedation during colonoscopy may be associated with improved detection of serrated polyps, but not adenomas.
Study context
- Population
- Patients aged >50 yr with screening or surveillance colonoscopies, New Hampshire Colonoscopy Registry, January 1, 2015 to February 28, 2020
- Participants
- 54,063 colonoscopies
- Exposure
- Propofol-based vs mild-moderate sedation for colonoscopy
- Propofoln = 29,312
- Moderate sedationn = 24,751reference
- Outcome
- Adenoma and serrated polyp detection
Methodological detailsregistry-based, multivariate logistic regression, propensity score adjustment, clustering at the endoscopist level
- Registry-based
- Multivariate logistic regression
- Propensity score adjustment
- Clustering at the endoscopist level
Main finding
As reported in the abstract
Serrated polyp prevalence (full sample)
Propofol vs Moderate sedationEstimate (95% CI)
Serrated polyp detection, multivariate logistic regression
OR 1.51(1.46–1.57)
Adenoma detection, multivariate logistic regression
OR 1.07(1.03–1.11)
Neoplasm detection
aOR 1.25(1.21–1.29)
Observational data: associations, not effects.
Further findings
| Outcome | Propofol | Moderate sedation |
|---|---|---|
| Serrated polyp prevalence, restricted sample | 30.3% (95% CI 28.9–31.6%) | 25.7% (95% CI 25.0–26.5%) |
- Serrated polyp prevalence, restricted sample: restricted sample: 18,998 colonoscopies
Polyp detection, restricted sample (IPTW propensity score adjustment, clustering at endoscopist level)
- Serrated polyps: attenuated but statistically significant effect, OR
- 1.13 (95% CI, 1.07 to 1.19)
- Adenomas: not significant, OR
- 1.00 (95% CI, 0.95 to 1.05)
- Any neoplastic lesion: not significant, OR
- 1.03 (95% CI, 0.98 to 1.08)
- Inverse probability of treatment weighted propensity score adjustment
Original publication
Association between Colonoscopy Sedation Type and Polyp Detection: A Registry-based Cohort Study. Anesthesiology. Published 17 April 2024. doi:10.
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