Non-bleeding Indications for Inpatient Colonoscopy

Abstract

Purpose: Multiple studies, including our own center's data, have shown that inpatient colonoscopy preparation is challenging and associated with a higher complication rate as compared to outpatients. We examined non-bleeding indications for inpatient colonoscopy to determine benefit of proceeding with such procedures vs. rescheduling to outpatient. Methods: Cross sectional study at a tertiary teaching hospital. Database comprised of 430 hospitalized patients undergoing inpatient colonoscopy (spanning a period of 10 months). Secondary analysis looking at indications for inpatient colonoscopy. Excluded ‘travel cases' and sigmoidoscopies. Results: Data shows that 35% inpatients had non-bleeding indications for colonoscopy. 10% of all patients underwent colonoscopy for diarrhea. Four percent of all patients had ‘abnormal CT' as an indication. Three percent of all patients underwent colonoscopy to ‘screen for malignancy/high risk surveillance/weight loss.' The remainder of non-bleeding indications (total of 18% of all inpatients) included Inflammatory Bowel Disease, bacteremia of unknown origin, constipation, pre-operative evaluation, abdominal pain, constipation and ‘not listed.' Conclusion: Published data has already shown that inpatient colonoscopy is a more challenging procedure than its outpatient counterpart. Our analysis suggests that many inpatient colonoscopies could potentially be rescheduled to the outpatient setting, avoiding prolongation of hospitalization, potential hazard of complications and reduction in cost. Subsequent analysis will focus on financial benefit to the healthcare system of having non-urgent colonoscopy rescheduled as outpatient.