Some features of patients are associated with inadequate bowel preparation, which reduces the effectiveness of colonoscopy examination.
Dr Kunjal Gandhi and colleagues from Pennsylvania, USA performed a systematic review and meta-analysis of the association between patients’ sociodemographic characteristics, health conditions, and medications with inadequate bowel preparation.
The doctors searched the PubMed, Scopus, and Cochrane Review databases for randomized controlled trials cohort, case–control, and cross-sectional studies published through 2016.
The team collected information on study design, study population, and bowel preparation.
For each factor, the researchers obtained the odds ratio for inadequate bowel preparation.
The research team conducted the meta-analyses using the random-effects approach and investigated any identified heterogeneity and publication bias via graphical methods, stratification, and meta-regression.
The doctors performed a meta-analysis of 67 studies, comprizing 75,818 patients.
The estimated pooled odds ratio for inadequate bowel preparation was small for sociodemographic characteristics, at 1.14 for age, and 1.23 for male sex and 1.49 for low education.
|The estimated pooled odds ratio for inadequate bowel preparation was small for sociodemographic characteristics
|Clinical Gastroenterology and Hepatology
The team noted that the effect of high body mass index differed significantly in studies with mostly female patients vs those with mostly male patients.
Odds ratios for constipation and cirrhosis were heterogeneous; adjusted odds ratios were larger than unadjusted odds ratios.
The researchers found that diabetes, hypertension, stroke or dementia and opioid use were associated with inadequate bowel preparation.
History of abdominal surgery did not associate with inadequate bowel preparation.
Use of tricyclic antidepressants had a larger effect on risk of inadequate bowel preparation in studies of mostly female patients than studies of mostly male
Dr Gandhi's team comments,"In a systematic review and meta-analysis, we found that health conditions and use of some medications appear to be stronger predictors than sociodemographic characteristics."