Quality of recovery after gastroscopy, colonoscopy, or both endoscopic procedures: an observational pilot study

BACKGROUND: Gastroscopy and colonoscopy are procedures with low complication rates and patients are usually discharged few hours after the procedures. Nevertheless, postoperative cognitive decline is a common condition, is often missed, and can potentially affect patients' ability to drive and undertake other daily living activities. The primary aim was to assess the incidence of failure to recover at Day 1 after either colonoscopy, gastroscopy, or both procedures combined.

METHODS: In an observational pilot study, participants of 18 years or above undergoing endoscopy procedures, including colonoscopy (reference group), gastroscopy, or both, were included. Postoperative quality of recovery was measured over a 1-month period using the "Postoperative Quality of Recovery Scale" assessing recovery in five subdomains.

RESULTS: In total, 102 participants were enrolled, comprised of 53 colonoscopy participants, 28 gastroscopy participants, and 21 "combined" participants. At Day 1, overall recovery in the colonoscopy group was 57%, compared to 45% in the gastroscopy group with an odds ratio of 1.6 (95% CI 0.5-4.9) and 40% in the "combined" group with an odds ratio of 2.0 (95% CI 0.6-6.9). Failure to recover was mainly due to failure in nociceptive and cognitive recovery at Day 1, which were 76% and 79% for colonoscopy participants, respectively, 61% and 84% for gastroscopy participants, compared with 63% and 60% for the "combined" group, respectively.

CONCLUSIONS: This study showed that incomplete recovery is common past discharge after gastroscopy, colonoscopy, or both procedures and the study demonstrated modest but clinically important differences in early quality of recovery between the procedures.