Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Gastroenterology and Hepatology, Antonius Hospital, Nieuwegein, The Netherlands.
Gastrointest Endosc. 2015 Mar;81(3):665-72. doi: 10.1016/j.gie.2014.09.066. Epub 2015 Jan 17.
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.
To develop a prediction score to identify patients at risk for inadequate bowel preparation who may benefit from an intensified bowel cleansing regimen.
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.
Four centers, including one academic and three medium-to-large size nonacademic centers.
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%).
Colonoscopy.
Inadequate bowel preparation defined as Boston Bowel Preparation Scale score <6.
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.
Study design partially retrospective, no data on patient compliance.
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.
充分的肠道准备对于优化结肠镜检查至关重要。识别肠道准备不足的高危患者非常重要，因为这可以让我们在这一特定人群中采取预防措施。
开发一种预测评分系统，以识别可能受益于强化肠道清洁方案的肠道准备不足的高危患者。
前瞻性收集患者和结肠镜检查数据，回顾性收集共 1996 例接受分次肠道准备的参与者的临床数据。在队列的三分之二随机进行多变量逻辑回归分析，以建立预测模型。在队列的三分之一中进行验证和评估预测模型的判别能力。
包括一家学术中心和三家中等至大型非学术中心在内的 4 家中心。
2012 年 11 月和 12 月连续进行的结肠镜检查。平均年龄为 57.3±15.9 岁，45.8%为男性，结肠镜检查的指征为筛查和/或监测（27%）、腹部症状和/或失血和/或贫血（60%）、炎症性肠病（9%）和其他（4%）。
结肠镜检查。
肠道准备不足定义为波士顿肠道准备量表评分<6。
共纳入 1331 例结肠镜检查，其中 172 例（12.9%）肠道准备不足。预测模型中纳入的独立因素包括美国麻醉医师协会身体状况分级系统评分≥3、三环类抗抑郁药、阿片类药物、糖尿病、慢性便秘、腹部和/或盆腔手术史、肠道准备不足史和当前住院治疗。该量表的判别能力良好，验证队列的曲线下面积为 0.77。
研究设计部分回顾性，无患者依从性数据。
我们开发了一种经过验证、易于使用的预测评分系统，可用于准确识别肠道准备不足的高危患者。
