TORNA ALL’ELENCO

What factors affect the quality of bowel preparation for colonoscopy? A multicenter prospective cohort study in Gastrointestinal Endoscopy

2011
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (19)Vedi tutti...

Bruno M

Rondonotti E

Hassan C


et alii...

Abstract

Background: Good bowel preparation is of paramount importance for colonoscopy since inadequate cleansing results in decreased rates of cecal intubation, increased risk of missing polyps, prolonged duration of colonoscopy and increased rate of repeated colonoscopies. The aim of this study was to identify factors that impact on the quality of bowel preparation and those that are associated with low patient acceptance. Methods: Adult outpatients referred for colonoscopy at 18 Italian centers were enrolled between May and September 2010. The following data were recorded for each patient: age and gender, body mass index (BMI), level of education, source of referral and indication for colonoscopy, medical history and current medications. The patients chose freely one of the scheduled types of bowel preparation available in each center, and the type and timing of bowel preparation, the type of instructions provided (written, verbal) and patient compliance with the cleansing protocol were recorded. The quality of bowel cleansing was assessed using a previously validated (Rex D, et al GIE 2006) 4-point scale (excellent, good, fair and poor) based on the amount and nature of residual material. For statistical analysis, bowel scores were grouped as adequate (excellent or good) or inadequate (fair or poor). Data were evaluated by univariate and multivariate logistic regression analysis. Results: Of 2811 outpatients who were enrolled (52% men, mean age 61 years), inadequate colonic preparation was observed in 925 (32.9%) colonoscopies. At multivariate analysis, inadequate cleansing was associated with male gender (p=0.0014), previous colonoscopy (p=0.0152), and a history of cirrhosis, diabetes or chronic invalidating co-morbidities (p=0.001). Conversely, good predictors of adequate preparation were: adherence to bowel preparation (=75% of the recommended dose; p=0.0001), use of sennosides or bisacodyl (p=0.05), an interval of less than 12 hours between the completion of b

DOI : 10.1016/j.gie.2011.03.998

Keywords

polyp; patient compliance; drug therapy; medical history; body mass; adult; risk; intubation; univariate analysis; taste; drinking; gender; education; outpatient; intestine; patient; cleaning; cohort analysis; colonoscopy; intestine preparation; bisacodyl; statistical analysis; multivariate logistic regression analysis; multivariate analysis; male; liver cirrhosis; diabetes mellitus; morbidity; recommended drug dose;