Aims:
Adequate bowel preparation is essential for effective examination of the colon at colonoscopy. Here, we looked at the quality of cleansing, limitations, risks and benefits of in-patient colonoscopies (IPC).
Methods:
All iPCs done in a 12-month period until March 2017 were analysed. Indications of the procedures, 30 day- mortality, quality of bowel preparation, time interval between the last dose of the preparation and procedure (TIPP), findings at endoscopy were analysed. Quality of cleansing was assessed using Aronchik scale.
Data were collected retrospectively using our endoscopy, investigation requesting portal, electronic patient records.
Results:
111 IPCs were done. Mean age of the patients was 65.4 years. Kleenprep (KP) was used in 77.5% and Picolax (PI) 12.6%. Compliance with KP was 81.4% and with PI was 92.8%. The main Indications included anaemia (30.6%), rectal bleeding (23.4%), change in bowel habits (20%) and abnormal imaging (9%).
Anaemia had the lowest diagnostic yield (8.8%) compared to abnormal radiology.(60%). The mean TIPP between was 9 hours. The mean TIPP of patients having adequate/excellent bowel cleansing was shorter than those with inadequate cleansing (7.76 hours vs. 11.35 hours p = 0.024)
61.6% of patients had adequate or excellent bowel cleansing. Procedures with adequate/excellent preparation had higher likelihood of being complete (91% vs. 73.8% p = 0.175). Procedures done in the afternoon had slightly better cleansing compared to those done in the morning (62% vs. 52% p = 0.41).
29% of IPCs found pathologies, such as cancer (5%) and colitis (7%). There were no procedural complications. 3 patients (2.7%) patients died within 30 days of colonoscopy for reasons unrelated to procedures.
Conclusions:
In-patient colonscopies are useful and safe tests, however they have lower completion rates usually due to poorer cleansing. Quality may be improved by limiting to certain indications and by having lower interval between last dose of preparation and colonoscopy.
