Study of Quality Indicators for On-site Colonoscopy Bowel Preparation Regimen: A Retrospective Analysis

Abstract

Introduction: Bowel preparation significantly influences the quality indicators of colonoscopy. Data on quality indicators of colonoscopy using on-site bowel preparation, which involves consuming a part of preparation at home the previous evening and part in the colonoscopy unit are very limited. This study is aimed at evaluating the impact of on-site bowel preparation on the rate of repeat colonoscopy and quality indicators. Methods: Retrospective data of all patients who underwent screening or surveillance colonoscopy in out patient clinic between Jan/2014 till Mar/2015 were collected. Inclusion criteria: Age>18 years and undergoing outpatient screening or surveillance colonoscopy. Exclusion criteria: History of colonic resection, known or suspected IBD, colon cancer, patients requiring repeat colonoscopies for reasons other than poor bowel preparation. The quality of bowel preparation was rated poor, fair, good and excellent based on the quality of bowel preparation. Statistical analysis was performed using one way ANOVA for continuous variables and Chi-square test for categorical variables. Results: 1761 colonoscopies (males 94.9%, Caucasians 64.1%, mean age 64±8 years, screening and surveillance colonoscopies, 53% and 43.6% respectively) were recorded (Table 1). Quality of bowel preparation: 76.3% excellent, 17.4% good, 4.6% fair and 1.7% poor. Only 1.7% colonoscopies were repeated in 15 months due to poor bowel preparation. The cecal intubation rate and screening colonoscopy SSA detection rates were significantly higher in patients with excellent and good bowel preparation compared to those with fair and poor bowel preparation (P=0.007 and P=0.04 respectively) (Table 2). The ADR although higher in patients with excellent and good bowel preparation, was not statistically significant (Table 2).Table 1: Descriptive statisticsConclusion: Most of the patients who received on-site bowel preparation had excellent or good bowel preparation (94%) with very low repeat colonoscopies due to poor bowel preparation. The cecal intubation rate and screening colonoscopy SSA detection rates were significantly higher in these groups of patients. Randomized multicenter trials should be conducted in future comparing the efficacy of on-site bowel preparation with the split-dose preparations on quality of bowel preparation and quality indicators of colonoscopy.Table 147b: Quality Indicators for Colonoscopy