Abstract

We examine the impact of key variables on the likelihood of inpatient poor bowel preparation for colonoscopy. Records of inpatients that underwent colonoscopy at our institution between January 2010 and December 2011 were retrospectively extracted. Univariable and multivariable logistic regression models were fitted to assess the effect of clinical variables on the odds of poor preparation. Tested predictors included age; gender; use of narcotics; heavy medication burden; comorbidities; history of previous abdominal surgery; neurological disorder; product used for bowel preparation, whether or not the bowel regimen was given as split or standard dose; and time of endoscopy. Overall, 244 patients were assessed including 83 (34.0%, 95% CI: 28.1–39.9%) with poor bowel preparation. Cecal intubation was achieved in 81.1% of patients (95% CI: 76.2–86.0%). When stratified by quality of bowel preparation, cecal intubation was achieved in only 65.9% (95% CI: 60.0–71.9%) of patients with poor bowel preparation and 89.9% (95% CI: 86.1–93.7%) of patient with good bowel preparation. In multivariate logistic regression analysis, only advancing age was an independent predictor of poor bowel preparation (OR = 1.026, CI: 1.006 to 1.045, and p = 0.008). Age is the only independent predictor of poor bowel preparation amongst hospitalized patients.

Highlights

  • The Multisociety Task Force on Colorectal Cancer recommends a target of 90% colonoscopy completion rate [1, 2], which is essential to meet the diagnostic and therapeutic aims of the procedure

  • Given the limited resources available and the cost of inadequate bowel preparation [13], we examine the impact of patient characteristics on the likelihood of poor bowel preparation at inpatient colonoscopy

  • The rate of complete colonoscopy in patients with poor bowel preparation was 65.9% compared to 89.9% in patients with good bowel preparation (p < 0.001)

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Summary

Introduction

The Multisociety Task Force on Colorectal Cancer recommends a target of 90% colonoscopy completion rate [1, 2], which is essential to meet the diagnostic and therapeutic aims of the procedure. The success of a colonoscopy relies on many factors, which include age, comorbidities, location of procedure, bowel preparation [3], and timing of endoscopy [4]. On the matter of bowel preparation, investigators have examined characteristics associated with an adequate bowel preparation. These include admission status, gender, age, obesity, socioeconomic status, comorbidities, insurance status, number and type of medications, and time of endoscopy, as well as time between preparation and endoscopy [4,5,6,7,8,9,10,11,12]. Given the limited resources available and the cost of inadequate bowel preparation [13], we examine the impact of patient characteristics on the likelihood of poor bowel preparation at inpatient colonoscopy

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