Endoscopy 2018; 50(04): S86-S87
DOI: 10.1055/s-0038-1637285
ESGE Days 2018 oral presentations
21.04.2018 – Colon cleansing
Georg Thieme Verlag KG Stuttgart · New York

FACTORS RELATED TO INADEQUATE COLON CLEANSING

C Mangas
1   Hospital General Universitario de Alicante, Alicante, Spain
,
E Santana
1   Hospital General Universitario de Alicante, Alicante, Spain
,
J Cubiella
2   Complexo Hospitalario Universitario de Ourense, Ourense, Spain
,
A Suárez
3   Hospital Universitario Central de Asturias, Oviedo, Spain
,
I Portillo
4   Hospital Donostia/Instituto Biodonostia, Universidad del País Vasco, San Sebastián, Spain
,
A Seoane
5   Parc de Salut Mar, Hospital del Mar, Barcelona, Spain
,
M Ponce
6   Hospital Universitari i Politècnic La Fe, Valencia, Spain
,
P Díez
7   Hospital Universitario Río Hortega, Valladolid, Spain
,
E Quintero
8   Hospital Universitario de Canarias, Universidad de La Laguna, Santa Cruz de Tenerife, Spain
,
M Herráiz
9   Clínica Universitaria de Navarra, Pamplona, Spain
,
M Pellisé
10   Hospital Clínic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
,
Á Ferrández
11   Hospital Clínico Lozano Blesa, Universidad de Zaragoza, CIBERehd, Zaragoza, Spain
,
V Hernández
12   Grupo de Investigación en Patología Digestiva, Vigo, Spain
,
Á Pizarro
13   Hospital Universitario Virgen del Rocío, Sevilla, Spain
,
R Jover
1   Hospital General Universitario de Alicante, Alicante, Spain
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Publikationsverlauf

Publikationsdatum:
27. März 2018 (online)

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    Aims:

    Adequate colon cleansing is mandatory to fulfil colonoscopy quality indicators, so the aim was to evaluate which factors were related to an inadequate colon cleasing.

    Methods:

    Observational, multicenter cross-sectional study. Colonoscopies performed during 2016. We included patients aged 40 – 80 yo, and four colonoscopy indications: gastrointestinal symptoms (GIS), fecal immunochemical test positive (FIT+), post-polypectomy surveillance (PPS) and primary screening colonoscopy (PSC).

    Definition of inadequate colon cleansing: 0 – 1 point using the Boston Bowel Preparation Scale in at least one colon segment.

    Results:

    8895 colonoscopies were included. 52.5% (4665) were men and the median age 62 years-old. The rate of inadequate colon cleansing was 12.7% (1055). Univariate and multivariate statiscal analysis were performed.

    Inadequate colon cleansing resulted in 17.3% (502) of patients with GIS (p < 0.001, aOR2.7, CI 95% 2.2 – 3.2), 14.3% (200) of PPS (p < 0.001, aOR1.9, CI 95% 1.5 – 2.3), 11.1% (70) of PSC (p = 0.003, aOR1.6, CI 95% 1.2 – 2.1) and 8.3% (281) of FIT+.

    Also, 13.5% (593) of men (p = 0.001, aOR1.3, CI 95% 1.1 – 1.5) and 13.8% (677) of patients ≥60 yo (p < 0.001, aOR1.3, CI 95% 1.1 – 1.5) had inadequate colon cleansing. Regarding the bowel preparation, 12.6% (242) of PEG4L (p-value: ns), 13.5% (418) of PEG2L (p-value: ns), 11.3% (342) of Napicosulphate/Mgcitrate (SPMC) (p = 0.001, aOR0.8, CI 95% 0.7 – 0.9) were poor prepared. In addition, 11.4% (281) same day (p = 0.005, aOR1.3, CI 95% 1.1 – 1.5), 20.6% (215) day before (p-value: ns) and 11.2% (532) split bowel preparation intake had inadequate preparation.

    16.3% (476) of patients who spent > 4h from the end of bowel preparation to the beginning of the procedure (p-value: ns), however 21.7% (282) of those who spent > 7h (p < 0.001, aOR2.8, CI 95% 2.0 – 3.9) had inadequate colon cleansing.

    No statiscal differences were found in regards to the working shift nor BMI.

    Conclusions:

    Colonoscopy indication, sex, age, same day bowel preparation intake and > 7h from the end of bowel preparation intake to the beginning of the procedure were independent factors that increased the risk of inadequate colon cleansing. However, the usage of SPMC was an independent factor that decreased the risk of inadequate colon preparation.


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