Factors associated with polyp detection during colonoscopy: A retrospective observational study

Abstract

The polyp detection rate (PDR) is an important quality indicator for colonoscopy. Several factors have been shown to be associated with PDR. However, whether the moderate sedation is a factor for polyp detection remains controversial. This study aims to assess factors associated with polyp detection including the moderate sedation factor during colonoscopy. Patients who underwent colonoscopy from June 1, 2014 to May 31, 2015 were enrolled into this retrospective study. Patients with poor colon preparation and failure to reach the cecum were excluded. The clinical factors, including patient's sex, age, midazolam/fentanyl sedation, indications, endoscopist colonoscopy volume, and use of antispasmodic agent were evaluated by multivariate analysis. A total of 3373 patients were included in this study. The mean age was 55.8 years, and 1980 patients (58.7%) were male. Among the 3373 patients, 2513 (74.5%) underwent midazolam/fentanyl‐based sedated colonoscopy. The multivariate analysis showed that male sex, age over 50 years old, midazolam/fentanyl sedation and indications of screening and surveillance were significantly associated with polyp detection. Moreover, when stratified by sex and age, the midazolam/fentanyl sedation was associated with polyp detection in male patients and patients over 50 years old. This study has highlighted the role of midazolam/fentanyl sedation administered by colonoscopists as a modifiable factor that may increase polyp detection during colonoscopy.

The effect of prophylactic hemoclip placement and risk factors of delayed post-polypectomy bleeding in polyps sized 6 to 20 millimeters: a propensity score matching analysis

“…However, the patient population was predominately male (> 95%), and whether their finding applies to female patients is uncertain. Although colorectal polyps is a male predominate disease [ 15 ], the female proportion in our study is approximately 30%, which is much higher than that in the previous study. Therefore, our study has a more balanced patient distribution leading to practical results based on clinical experience.…”

Gastrointestinal endoscopy nurse assistance during colonoscopy and polyp detection

“…Fourth, other factors such as withdrawal time and sedation administered were inconsistent or not reported. [ 19 , 20 ] Fifth, our results shown that no statistically significant difference of the advanced lesions detection rate was found. Due to the small sample size of each trial and small number of advanced lesions, type II error appears to be quite likely exist.…”

Comparison of three sedation models for same‐day painless bidirectional endoscopy: A multicenter randomized controlled trial

“…20 However, deep-sedated colonoscopy is conducted entirely in the left lateral position because it is difficult to move a deep-sedated patient to change their position, and the supine position during deep sedation may increase respiratory movements, choking rates, and other respiratory problems. 21 Several studies demonstrated that the use of sedation during colonoscopy increased the ADR comparing with unsedated colonoscopy, but they did not mention whether dynamic position changes were performed in unsedated colonoscopy, [22][23][24][25][26] which may underestimate the quality of unsedated colonoscopy. As shown in the present study, the ADRs in all three groups were high and did not differ significantly from each other.…”