Safety of Gastrointestinal Endoscopy in Korea: A Nationwide Survey and Population-Based Study

Background: Attention should be paid to endoscopy-related complications and safety-related accidents that may occur in the endoscopy unit. This study investigated the current status ofcomplications associated with diagnostic and therapeutic endoscopy in Korea.Methods: A questionnaire survey on endoscopy-related complications was conductedin a total of 50 tertiary or general hospitals in Korea. The results were compared to thepopulation-level claims data from the Health Insurance Review & Assessment Service(HIRA), which analyzed endoscopy procedures conducted in 2017 in Korea.Results: The incidences of bleeding associated with diagnostic and therapeuticesophagogastroduodenoscopy (EGD) and with diagnostic and therapeutic colonoscopy were0.224% and 3.155% and 0.198% and 0.356%, respectively, in the 2017 HIRA claims data,compared to 0.012% and 1.857%, and 0.024% and 0.717%, in the 50 hospitals surveyed.The incidences of perforation associated with diagnostic and therapeutic EGD and withdiagnostic and therapeutic colonoscopy were 0.023% and 0.613%, and 0.007% and 0.013%,respectively, in the 2017 HIRA claims data compared to 0.001% and 0.325%, and 0.017%and 0.206%, in the 50 hospitals surveyed. In the HIRA claims data, the incidence ofbleeding/perforation after diagnostic colonoscopy in clinics, community hospitals, generalhospitals, and tertiary hospitals was 0.129%/0.000%, 0.088%/0.004%, 0.262%/0.009%,and 0.479%/0.030% respectively, and the corresponding incidence of bleeding/perforationafter therapeutic colonoscopy was 0.258%/0.004%, 0.401%/0.007%, 0.408%/0.024%, and0.731%/0.055%.Conclusion: