The researchers investigated predictors of inadequate bowel preparation for colonoscopy, and reported their finding in June's American Journal of Gastroenterology.
Inadequate preparation can result in both missed pathological lesions and cancelled procedures.
The team looked prospectively at the quality of colonic preparation, and evaluated potential associations between specific patient characteristics and inadequate colonic preparation.
Complete data was gathered on 649 consecutive patients presenting for colonoscopy, who received either a polyethylene glycol lavage or oral sodium phosphate bowel preparation.
Patient demographic and medical history information was gathered before scheduled colonoscopy.
The endoscopist evaluated the preparation quality during the procedure.
Possible predictors of inadequate colonic preparation were analyzed using univariate statistics and multivariate logistic regression models.
|Inadequate colonic preparation in 22% of colonoscopies.|
|Am J Gastroenterol |
An inadequate colonic preparation was reported in 22% of observed colonoscopies.
The researchers found that only 18% of patients with an inadequate colonic preparation reported a failure to follow preparation instructions adequately.
A later colonoscopy starting time, a reported failure to follow preparation instructions, and inpatient status were all independent predictors of an inadequate colon preparation. Other independent predictors included a procedural indication of constipation, taking tricyclic antidepressants, male gender, and a history of cirrhosis, stroke, or dementia.
A procedural indication of previous polypectomy was found to be a negative predictor of inadequate colonic preparation.
Author R. M. Ness, of the Indiana University School of Medicine, Indianapolis, concluded on behalf of the group, "Several patient characteristics were significantly associated with colonic preparation quality, independent of preparation type, compliance with preparation instructions, and procedure starting time.
"This information may help to identify patients at an increased risk for inadequate colonic preparation for whom alternative preparation protocols would be appropriate."