Yee Ruby, Manoharan Shiana, Hall Christine, Hayashi Allen
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Am J Surg. 2015 May;209(5):787-92; discussion 792. doi: 10.1016/j.amjsurg.2014.12.018. Epub 2015 Feb 12.
This retrospective study evaluates factors that are associated with an inadequate bowel preparation.
A chart review was performed on 2,101 patients who underwent colonoscopy. The quality of preparation was classified as adequate or inadequate. Univariate and multivariate regression analyses identified factors associated with inadequate preparations.
A total of 91.5% of preparations were adequate. Standard preparations using polyethylene glycol-electrolyte solution and sodium picosulfate alone were 91.1% adequate. Regimens with adjuncts were 91.9% adequate. Factors that predicted an inadequate preparation include the following: stroke/dementia (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.6 to 7.7, P = .002), opioids (OR 2.3, 95% CI 1.1 to 4.6, P = .02), male sex (OR 2.0, 95% CI 1.4 to 2.9, P = .000), calcium channel blockers (OR 1.9, 95% CI 1.1 to 3.3, P = .03), and antidepressants (OR 1.7, 95% CI 1.1 to 2.7, P = .02).
Several factors are associated with inadequate preparations. Adjuncts do not improve preparation quality. The effect of patient education on preparation quality is an area for further research.
这项回顾性研究评估了与肠道准备不充分相关的因素。
对2101例行结肠镜检查的患者进行病历审查。准备质量分为充分或不充分。单因素和多因素回归分析确定了与准备不充分相关的因素。
总共91.5%的准备是充分的。单独使用聚乙二醇电解质溶液和匹可硫酸钠的标准准备充分率为91.1%。使用辅助药物的方案充分率为91.9%。预测准备不充分的因素包括：中风/痴呆（比值比[OR]3.5，95%置信区间[CI]1.6至7.7，P = 0.002）、阿片类药物（OR 2.3，95%CI 1.1至4.6，P = 0.02）、男性（OR 2.0，95%CI 1.4至2.9，P = 0.000）、钙通道阻滞剂（OR 1.9，95%CI 1.1至3.3，P = 0.03）和抗抑郁药（OR 1.7，95%CI 1.1至2.7，P = 0.02）。
有几个因素与准备不充分相关。辅助药物并不能提高准备质量。患者教育对准备质量的影响是一个有待进一步研究的领域。
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