Quality of bowel cleansing in hospitalized patients undergoing colonoscopy: A multicentre prospective regional study

Rotondano, G.; Rispo, Antonio; Bottiglieri, Maria Erminia; Luca, Leonardo De; Lamanda, R.; Orsini, L.; Bruzzese, Dario; Galloro, Giuseppe; Romano, Marco; Miranda, Agnese; Loguercio, C.; Esposito, Pasquale; Nardone, Gerardo; Compare, Debora; Magno, Luca; Ruggiero, Simona; Imperatore, Nicola; Palma, Giovanni D De; Gennarelli, Nicola; Cuomo, Rosario; Passananti, Valentina; Cirillo, Michele; Cattaneo, D.; Bozzi, R.; D’Angelo, Valentina; Marone, Piero; Riccio, Elisabetta; Nucci, C. De; Monastra, S.; Caravelli, G.; Verde, Clelia; Giorgio, P. Di; Giannattasio, Francesco; Capece, Giuseppe; Taranto, Domenico; Seta, Massimiliano De; Spinosa, Giuseppe; Stefano, S. De; Familiari, V.; Cipolletta, Livio; Bianco, Maria Antonia; Sansone, Stefano; Galasso, Giovanni; Colibus, P. De; Romano, Maurizio; Borgheresi, P.; Ricco, G.; Martorano, Marco; Gravina, Antonietta Gerarda; Marmo, Riccardo; Rea, Matilde; Maurano, Attilio; Labianca, O.; Colantuoni, Enrico; Iuliano, D.; Trovato, Claudio; Fontana, A.; Pasquale, Luigi; Morante, Aristide; Perugini, B; Scaglione, Giuseppe; Mauro, Biagio

doi:10.1016/j.dld.2015.04.013

Cited by 25 publications

(20 citation statements)

References 32 publications

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“…We also found that diabetes was a predictor of poor bowel preparation quality; a result that has been observed in other studies,[ 18 20 ] whether this is a true predictor of a poor bowel preparation quality or a marker of overall co-morbidity is not clear, also whether autonomic dysfunction would play a role in this finding via affecting bowel motility is a possibility but to draw such a conclusion from this study would be premature as we do not have details about the duration of diabetes, nor the medications used or the adequacy of glycemic control. Other investigators found that predictors of a good bowel preparation were adherence to the preparation instructions, and the use of sodium phosphate preparations.…”

Section: Discussionsupporting

confidence: 88%

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Bowel preparation quality between hospitalized patients and outpatient colonoscopies

Almadi

Alharbi

Azzam

et al. 2018

Saudi J Gastroenterol

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Background/Aims:Optimal bowel preparation is essential for a complete high-quality colonoscopy. We sought to determine whether an inpatient, as opposed to an ambulatory setting, would affect the quality of bowel preparation.Patients and Methods:A retrospective chart review was conducted in a tertiary care university hospital. We collected demographic data from consecutive patients who underwent a colonoscopy for any reason between August 2007 and April 2012.Results:A total of 2999 patients were included in the study with a mean age of 50.36 (95%CI; 49.79–50.94). Males comprised 58.12%. Ambulatory patients had a higher rate of good bowel preparations (67.23% vs. 56.64%, P value < 0.01), a lower rate of poor bowel preparations (18.22% vs. 27.14%, P value < 0.01), and a higher rate of colonoscopy completion (86.79% vs. 77.59%, P value < 0.01). There was no difference between the rates of polyps detected (18.90% vs. 20.83%, P value = 0.22). The univariabe modeling factors associated with a sub-optimal bowel preparation were age OR 1.02 (95% CI, 1.01 to 1.02), chronic kidney disease OR 2.34 (95% CI, 1.12 to 4.88), diabetes mellitus OR 2.00 (95% CI, 1.50 to 2.68), hypertension OR 1.48 (95% CI, 1.11 to 1.97), anemia OR 1.81 (95% CI, 1.33 to 2.47), and weight loss OR 1.41 (95% CI, 1.01 to 1.96). Better bowel preparation was associated with colonoscopies performed in the outpatient setting OR 0.63 (95% CI, 0.54 to 0.73).Conclusion:Bowel preparation quality is affected by the setting in which it is performed. This result suggests that, when appropriate, colonoscopies should be performed on an outpatient basis. Further studies are required to replicate this finding.

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Section: Discussionsupporting

confidence: 88%

“…This may have been due to the fact that, in that study, about 48% of the inpatient colonoscopies were performed for screening or surveillance purposes. [ 18 ]…”

Section: Discussionmentioning

confidence: 99%

Bowel preparation quality between hospitalized patients and outpatient colonoscopies

Almadi

Alharbi

Azzam

et al. 2018

Saudi J Gastroenterol

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“…Therefore, we found it important to assess possible predictors of inadequate bowel preparation that can help guide future improvement in institutional procedure planning. In our cohort of hospitalized patients, 43% had inadequate bowel preparation, which is a high rate compared with previous studies, and this contributed to a low cecal intubation rate of 52% and polyp detection not meeting guideline recommendations (2,4,(12)(13)(14). We found that patients having colonoscopy in the afternoon were less likely to have successful bowel preparation (OR=0.32, 95% CI=0.14-0.74, p=0.007).…”

Section: Discussionmentioning

confidence: 47%

Predictors of inadequate bowel preparation for inpatient colonoscopy

Jawa

Mosli²,

Alsamadani³

et al. 2017

Turk J Gastroenterol

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“…Even though we routinely provided direct education about the preparation methods to all patients scheduled for a colonoscopy, patient acceptance differs from person to person. In addition, high-residue diet, constipation, and high body mass index may be risk factors for inadequate bowel preparation 8,22,26,27 and possible confounders. Third, the choice of formulation is inevitably affected by the physician's preference and the patient's medical status.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Inadequate bowel preparation can reduce the ADR, and increase procedure time and the resultant patient discomfort, the risk of complications, and the costs associated with shortened surveillance intervals. [6][7][8][9] The choice of an effective and tolerable preparation regimen is of utmost importance. Several Food and Drug Administration (FDA)-approved formulations for bowel cleansing are currently used, including polyethylene glycol (PEG)-electrolyte lavage solution, for example, 4 L PEG and 2 L PEG plus ascorbic acid (PEG-AA); oral sulfate solution (OSS); sodium picosulfate; and sodium phosphate in limited use.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

et al. 2020

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Background/Aims: The quality of bowel preparation is one of the quality indicators for colonoscopy. The aim of this study was to compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol plus ascorbic acid (PEG-AA) for bowel preparation. Methods: The study involved 167 patients who underwent diagnostic colonoscopies. Inadequate bowel preparation was defined as any score of ≤1 in each colon section based on the Boston Bowel Preparation Scale. Multivariate logistic regression was used to compare the efficacy of OSS and PEG-AA. Subgroup analyses were performed based on patient characteristics. Results: Overall, 106 (63.5%) patients received OSS, and 61 (36.5%) patients received PEG-AA. The rate of inadequate bowel preparation was 12.3% in patients receiving OSS and 32.8% in patients receiving PEG-AA (p=0.001). OSS (odds ratio [OR] = 0.26; p=0.003) and morning examination (OR=0.11; p=0.038) were significantly associated with efficient bowel preparation. The efficacy of OSS compared with PEG-AA was only significant in patients ≥50 years of age vs. <50 years of age (OR=0.13; p=0.001 vs. OR=0.96; p=0.959) and female vs. male patients (OR=0.06; p=0.002 vs. OR=0.58; p=0.339). Conclusions: OSS was significantly more efficient for bowel preparation than PEG-AA, especially in patients ≥50 years of age and female patients. Morning examination led to a good quality of bowel preparation, irrespective of the preparation regimen. Clin Endosc 2020 Apr 24.

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Quality of bowel cleansing in hospitalized patients undergoing colonoscopy: A multicentre prospective regional study

Cited by 25 publications

References 32 publications

Bowel preparation quality between hospitalized patients and outpatient colonoscopies

Bowel preparation quality between hospitalized patients and outpatient colonoscopies

Predictors of inadequate bowel preparation for inpatient colonoscopy

Comparison of Oral Sulfate Solution and Polyethylene Glycol Plus Ascorbic Acid on the Efficacy of Bowel Preparation

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