Mitchell R M S, McCallion K, Gardiner K R, Watson R G P, Collins J S A
Department of Medicine, Royal Victoria Hospital, Belfast.
Ulster Med J. 2002 May;71(1):34-7.
Factors such as poor bowel preparation or obstructing colonic disease may confound the reporting of colonoscopy completion rates, as these factors are outside of the control of the endoscopist performing the procedure. By adjusting for these factors when calculating a colonoscopy completion rate, it may be possible to make a more accurate assessment of a unit's or individuals' competence. Details of two thousand two hundred and sixteen colonoscopies performed by four consultants and their trainees between 1993-2000 were analysed retrospectively from a prospective endoscopy database. Crude (all cases) and adjusted (excluding poor bowel preparation and disease as causes of incompletion) rates were recorded for each sex, and by age according to cause. Overall crude and adjusted completion rates were 77.9% and 85.0% respectively. There was a significant difference between male and female completion rates due to a difference in the incidence of excess looping and intolerance of the procedure (adjusted rate 88.9% in males vs. 81.6% in females, p<0.05). There was a non-significant trend to lower completion rates in patients over 75 years of age compared to younger patients. Completion rates were significantly higher following bowel resection (adjusted rates 93.5% vs. 82.8%, p<0.05). There was no significant difference between completion rates for inpatient and outpatient referrals (P=0.36). Reporting colonoscopy completion rates by adjusting for factors such as poor bowel preparation and obstructing colonic disease allows for direct comparisons of completion rates reported by different units. Reporting completion rates in this way also highlights the effect of inadequate bowel preparation on successful colonoscopy.
诸如肠道准备不佳或结肠梗阻性疾病等因素可能会混淆结肠镜检查完成率的报告，因为这些因素超出了实施该检查的内镜医师的控制范围。在计算结肠镜检查完成率时对这些因素进行调整，可能会更准确地评估一个单位或个人的能力。从一个前瞻性内镜数据库中对1993年至2000年间由四位顾问及其受训人员进行的2216例结肠镜检查的详细信息进行了回顾性分析。记录了每种性别以及按原因划分的各年龄段的粗率（所有病例）和调整率（不包括因肠道准备不佳和疾病导致未完成检查的情况）。总体粗完成率和调整完成率分别为77.9%和85.0%。由于肠襻过多的发生率和对该检查的耐受性存在差异，男性和女性的完成率存在显著差异（调整率男性为88.9%，女性为81.6%，p<0.05）。与年轻患者相比，75岁以上患者的完成率有降低的趋势，但无统计学意义。肠切除术后的完成率显著更高（调整率93.5%对82.8%，p<0.05）。住院患者和门诊患者转诊的完成率之间无显著差异（P = 0.36）。通过对诸如肠道准备不佳和结肠梗阻性疾病等因素进行调整来报告结肠镜检查完成率，能够直接比较不同单位报告的完成率。以这种方式报告完成率还突出了肠道准备不充分对结肠镜检查成功的影响。
