Tu1170 RISK FACTOR ANALYSIS OF CECAL INTUBATION RATES AND QUALITY OF BOWEL PREPARATION IN THE ELDERLY: A TERTIARY HEALTH NETWORK STUDY

Abstract

Colonoscopy is an important tool in the diagnosis and management of colonic disorders. Adequate bowel preparation (BP) and completion of the colonoscopy, as measured by cecal intubation (CI) rates, are imperative for successful colonoscopy. Elderly patients generally have lower functional ability, higher co-morbidity and decreased colonic motility which may negatively impact CI and BP. Currently, there is limited data about CI and BP in the elderly population. We hope to determine the impact of various factors that can affect CI and BP in patients 75 years of age and above. (582) We conducted a retrospective chart review to identify patients who underwent colonoscopy between 2012 and 2019 within our health network. We collected data on patient characteristics, quality of bowel preparation and cecal intubation rates. All statistical analyses were conducted in IBM SPSS for Windows Version 26 to compute means and frequencies of patient characteristics and colonoscopy outcomes. Chi –Square tests were done to test differences between various categorical variables, and odds ratios were evaluated to test for associations between potential risk factors and BP and CI rates. A total of 387 patients were included with median age of 79 years, 44.4% males and 88.9% Caucasian. Most of the of colonoscopies (71.3%) were performed for a diagnostic indications. 51.2% were on Aspirin and 29.7% were obese. We found that 91.8% of patients had a good bowel preparation, and cecal intubation was achieved in 94.1% of colonoscopies. Table 1 includes a complete list of patient characteristics. Subgroup analysis showed larger proportion of patients with obesity, impaired fasting glucose, metabolic syndrome, fatty liver, constipation, ASA score 3 or more, and current smokers in the younger (75-84 years) age group, while older (85-95 years) patients had more coronary artery disease, aortic stenosis, intake of Aspirin and opioids and poor BP. Statistically significant risk factors for poor bowel preparation include being a current smoker (OR 2.79, 95% CI 0.98-7.94). Chronic obstructive pulmonary disease (COPD) (OR 2.67, 95% CI 0.92-7.71)and use of NSAIDs (OR 2.83, 95% CI 1.05-7.68) or opioid medications (OR 3.76, 95% CI 1.37-10.3) were associated with failure of CI. Table 2 includes additional risk factors assess for poor CI rates and inadequate BP. Ethnicity, increased age, and use of Aspirin had no adverse impact on CI or BP. Colonoscopy in the elderly was found to have high CI and BP rates. Our study found certain risk factors were associated with adverse impact on both parameters, while a lower BMI is associated with improved outcomes. Our study is limited by retrospective nature and lack of ethnic diversity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)