TY - JOUR
T1 - Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation
T2 - Development and validation of a prediction score
AU - Dik, Vincent K.
AU - Moons, Leon M G
AU - Hüyük, Melek
AU - Van Der Schaar, Peter
AU - De Vos Tot Nederveen Cappel, Wouter H.
AU - Ter Borg, Pieter C J
AU - Meijssen, Maarten A C
AU - Ouwendijk, Rob J T H
AU - Le Fèvre, Doris M.
AU - Stouten, Merijn
AU - Van Der Galiën, Onno
AU - Hiemstra, Theo J.
AU - Monkelbaan, Jan F.
AU - van Oijen, Martijn G. H.
AU - Siersema, Peter D.
AU - Tang, Thjon J.
AU - Ter Borg, Frank
AU - Kuipers, Ernst J.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group.Objective: To develop a prediction score to identify patients at risk for inadequate bowel preparation who may benefit from an intensified bowel cleansing regimen.Design: Patient and colonoscopy data were prospectively collected, whereas clinical data were retrospectively collected for a total of 1996 colonoscopies in participants who received split-dose bowel preparation. Multivariate logistic regression analyses were conducted in a random two-thirds of the cohort to develop a prediction model. Validation and evaluation of the discriminative power of the prediction model were performed within the remaining one-third of the cohort. Setting: Four centers, including one academic and three medium-to-large size nonacademic centers.Patients: Consecutive colonoscopies in November and December 2012. Mean age was 57.3 ± 15.9 years, 45.8% were male and indications for colonoscopy were screening and/or surveillance (27%), abdominal symptoms and/or blood loss and/or anemia (60%), inflammatory bowel disease (9%), and others (4%). Interventions: Colonoscopy. Main Outcome Measurements: Inadequate bowel preparation defined as Boston Bowel Preparation Scale score <6. Results: A total of 1331 colonoscopies were included in the development cohort, of which 172 (12.9%) had an inadequate bowel preparation. Independent factors included in the prediction model were American Society of Anesthesiologists Physical Status Classification System score ≤3, use of tricyclic antidepressants, use of opioids, diabetes, chronic constipation, history of abdominal and/or pelvic surgery, history of inadequate bowel preparation, and current hospitalization. The discriminative ability of the scale was good, with an area under the curve of 0.77 in the validation cohort.Limitations: Study design partially retrospective, no data on patient compliance. Conclusion: We developed a validated, easy-to-use prediction scale that can be used to identify subjects with an increased risk of inadequate bowel preparation with good accuracy.
AB - Background: Adequate bowel preparation is important for optimal colonoscopy. It is important to identify patients at risk for inadequate bowel preparation because this allows taking precautions in this specific group.Objective: To develop a prediction score to identify patients at risk for inadequate bowel preparation who may benefit from an intensified bowel cleansing regimen.Design: Patient and colonoscopy data were prospectively collected, whereas clinical data were retrospectively collected for a total of 1996 colonoscopies in participants who received split-dose bowel preparation. Multivariate logistic regression analyses were conducted in a random two-thirds of the cohort to develop a prediction model. Validation and evaluation of the discriminative power of the prediction model were performed within the remaining one-third of the cohort. Setting: Four centers, including one academic and three medium-to-large size nonacademic centers.Patients: Consecutive colonoscopies in November and December 2012. Mean age was 57.3 ± 15.9 years, 45.8% were male and indications for colonoscopy were screening and/or surveillance (27%), abdominal symptoms and/or blood loss and/or anemia (60%), inflammatory bowel disease (9%), and others (4%). Interventions: Colonoscopy. Main Outcome Measurements: Inadequate bowel preparation defined as Boston Bowel Preparation Scale score <6. Results: A total of 1331 colonoscopies were included in the development cohort, of which 172 (12.9%) had an inadequate bowel preparation. Independent factors included in the prediction model were American Society of Anesthesiologists Physical Status Classification System score ≤3, use of tricyclic antidepressants, use of opioids, diabetes, chronic constipation, history of abdominal and/or pelvic surgery, history of inadequate bowel preparation, and current hospitalization. The discriminative ability of the scale was good, with an area under the curve of 0.77 in the validation cohort.Limitations: Study design partially retrospective, no data on patient compliance. Conclusion: We developed a validated, easy-to-use prediction scale that can be used to identify subjects with an increased risk of inadequate bowel preparation with good accuracy.
KW - PREPARATION SCALE
KW - SCREENING COLONOSCOPY
KW - PREPARATION QUALITY
KW - REPEAT COLONOSCOPY
KW - IMPROVES QUALITY
KW - IMPACT
KW - BISACODYL
KW - CITRATE
KW - RATES
UR - http://www.scopus.com/inward/record.url?scp=84923489420&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2014.09.066
DO - 10.1016/j.gie.2014.09.066
M3 - Article
C2 - 25600879
AN - SCOPUS:84923489420
SN - 0016-5107
VL - 81
SP - 665
EP - 672
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 3
ER -