Colonoscopy Complications in Persons with Spinal Cord Injury - worth the risk?

Abstract Objective Prevalence of anemia in persons with spinal cord injury is higher than their able-bodied counterparts at 50-80%. The etiology is multifactorial but likely related to chronic whole-body inflammation. Chronic anemia is often an indication of gastrointestinal blood loss leading to a diagnostic colonoscopy. However, colonoscopies in persons with spinal cord injury are not without complications. We tested the hypothesis that, despite a high incidence of anemia, performing a colonoscopy in persons with spinal cord injury has a high complication rate and low rate of finding high risk pathology. Design Retrospective chart review Subjects 41 persons with chronic spinal cord injury admitted for colonoscopy from 2019-2024. Methods Percent of complications and abnormal findings were calculated. A logistic regression model determined predictors of complications and abnormal findings. Results Anemia prevalence was 59.1% with a complication rate of 38.6% and 59 abnormal findings in 95.2% of CSPs (n=4 (6.8%), high-risk pathology). Persons with anemia had a higher risk of complications and a decreased risk of hemorrhoids. Conclusion In persons with spinal cord injury, given a low-rate high risk pathology in the setting of a high complication rate, especially in persons with anemia, the risk of complications should be weighed more heavily in the decision to perform a colonoscopy.