P O Hendry1, J T Jenkins, R H Diament. 1. Department of Surgery, Crosshouse Hospital, Kilmarnock, UK. paulhendry77@btinternet.com
Abstract
OBJECTIVE: Colonoscopy is regarded as the most sensitive method of evaluating the colon. Inadequate preparation reduces sensitivity and has adverse implications for individual patients and the Heath Service. METHOD: Data concerning the adequacy of bowel preparation and colonoscopy completion rates were prospectively collected on all colonoscopies performed in a single centre between January 1996 and January 2005. In addition, the strategy of further investigation in the event of incomplete examination was assessed. RESULTS: A total of 10 571 colonoscopies were assessed and poor bowel preparation was identified in 1788 of these cases (16.9%). The completion rate was 67.5% in those with satisfactory preparation. In patients with poor preparation, 36% of colonoscopies were complete. Incomplete examination was more likely with poor preparation [OR = 3.76 (95% CI, 3.38-4.18), P = 0.0005]. Poor preparation was more likely for inpatients [OR = 3.54 (95% CI 3.14-3.96), P = 0.0005]. Even with satisfactory preparation, inpatient completion rates were significantly less [OR = 1.78 (95% CI, 3.14-3.96), P = 0.0005). A further 542 diagnostic procedures were undertaken in the poor preparation group, an additional pound101 950 (euro149 459) in expenditure. CONCLUSION: This study supports the view that inpatients fare badly. This is partly explained by higher rates of poor preparation; however, completion rates were reduced even with adequate preparation. Failed investigation and prolonged hospital stay increase cost. Colonoscopy completion rates need to be improved with particular attention to inpatients.
OBJECTIVE: Colonoscopy is regarded as the most sensitive method of evaluating the colon. Inadequate preparation reduces sensitivity and has adverse implications for individual patients and the Heath Service. METHOD: Data concerning the adequacy of bowel preparation and colonoscopy completion rates were prospectively collected on all colonoscopies performed in a single centre between January 1996 and January 2005. In addition, the strategy of further investigation in the event of incomplete examination was assessed. RESULTS: A total of 10 571 colonoscopies were assessed and poor bowel preparation was identified in 1788 of these cases (16.9%). The completion rate was 67.5% in those with satisfactory preparation. In patients with poor preparation, 36% of colonoscopies were complete. Incomplete examination was more likely with poor preparation [OR = 3.76 (95% CI, 3.38-4.18), P = 0.0005]. Poor preparation was more likely for inpatients [OR = 3.54 (95% CI 3.14-3.96), P = 0.0005]. Even with satisfactory preparation, inpatient completion rates were significantly less [OR = 1.78 (95% CI, 3.14-3.96), P = 0.0005). A further 542 diagnostic procedures were undertaken in the poor preparation group, an additional pound101 950 (euro149 459) in expenditure. CONCLUSION: This study supports the view that inpatients fare badly. This is partly explained by higher rates of poor preparation; however, completion rates were reduced even with adequate preparation. Failed investigation and prolonged hospital stay increase cost. Colonoscopy completion rates need to be improved with particular attention to inpatients.
Authors: Kyong Joo Lee; Hong Jun Park; Hyun-Soo Kim; Kwang Ho Baik; Yeon Soo Kim; Sung Chul Park; Hyun Il Seo Journal: World J Gastroenterol Date: 2015-03-14 Impact factor: 5.742
Authors: Alexander Lee; John M Iskander; Nitin Gupta; Brian B Borg; Gary Zuckerman; Bhaskar Banerjee; C Prakash Gyawali Journal: Am J Gastroenterol Date: 2011-03-29 Impact factor: 10.864