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DOI: 10.1055/s-0039-1681755
VALIDATION OF A SCORE PREDICTING INADEQUATE BOWEL PREPARATION BEFORE COLONOSCOPY IN HOSPITALIZED PATIENTS
Publication History
Publication Date:
18 March 2019 (online)
Aims:
Dik score* has been evaluated in the Netherlands to predict inadequate bowel preparation before colonoscopy among in- and out- patients We aimed to validate it using a cohort of Greek inpatients.
Methods:
Post-hoc cohort analysis of the data from inpatients undergoing colonoscopy in 4 tertiary greek centers. Dik Score is calculated taking into account patient's ASA Score, history of tricyclic antidepressants or opioid ingestion, history of diabetes melitus, history of abdominal or pelvic surgery, history of inadequate bowel preparation and current hospitalization. The Area Under the Curve (AUROC) was used to calculate Dik score's discriminative ability. For each cut-off we determined its sensitivity, specificity, positive (PPV) and negative prognostic value (NPV).
Results:
We enrolled 261 patients (161 ambulatory, 140 men, 70.7 ± 15.4 years old). In 89/261 (34.1%) patients bowel preparation was considered inadequate (BBPS< 6). Dik Score showed a sufficient discriminative ability for the entire cohort [AUROC (95% CI)= 0.69 (0.62 – 0.76)], while it performed better among bedridden compared to ambulatory patients [0.75 (0.65 – 0.85) vs. 0.58 (0.48 – 0.68), respectively]. In the entire cohort sensitivity, specificity, PPV and NPV for score ≥2 and ≥3 were 81.6%, 44.3%, 43.3%, 82.2% and 59.8%, 68.9%, 50%, 76.7%, respectively. Among bedridden and ambulatory patients sensitivity, specificity, PPV and NPV for score ≥2 were 95.7%, 21.2%, 52.3%, 84.6% and 65%, 54.8%, 33.3%, 81.8%, respectively and for score ≥3 89.4%, 51.9%, 62.7%, 84.4% and 25%, 76.5%, 27%, 74.6%, respectivley.
Conclusions:
In a cohort of Greek hospitalized patients Dik score ≥2 predicts sufficiently those with inadequate bowel preparation before colonoscopy. Moreover, among bedridden patients Dik score ≥3 can be used to further increase sensitivity without affecting specificity.
*Dik et al. Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation... Gastrointestinal Endoscopy 2012.
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