A team from the USA identified predictive factors of a difficult colonscopy.
Prediction of a technically difficult colonoscopy may influence patient selection and procedure scheduling.
Identification of predictive factors may be difficult because a common endpoint used to evaluate the success of colonoscopy is intubation of the cecum, which is usually achieved.
The researchers examined the feasibility of using the time required for cecal intubation as an alternative measure.
This measurement was prospectively recorded for 802 consecutive outpatient colonoscopies, performed by 7 experienced gastroenterologists.
|Difficult colonoscopy predictors include:|
- Female gender
- Older age
- BMI ≤25
| Gastrointestinal Endoscopy |
Patient data collected included height, weight, age, bowel habits, surgical history, and findings at colonoscopy.
Some 47 examinations were stopped because of disease or unacceptable bowel preparation. These were excluded from the study.
The impact of the patient characteristics, of the remaining sample of 755 patients, on the median time required for cecal intubation was examined.
The team found that older age and female gender were both predictors of difficult colonoscopy.
Body mass index ≤25.0 (regardless of gender), diverticular disease in women, and a history of constipation or reported laxative use in men were also predictors of difficult colonoscopy.
Dr Joseph C. Anderson, of the State University of New York at Stony Brook, concluded on behalf of his colleagues, "By using median time required for cecal intubation, several patient characteristics were identified that may predict technical difficulty at colonoscopy.
"These findings have implications for practice and teaching."