Kumar Akash, Lin Lisa, Bernheim Oren, Bagiella Emilia, Jandorf Lina, Itzkowitz Steven H, Shah Brijen J
Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Gut Liver. 2016 Jul 15;10(4):569-73. doi: 10.5009/gnl15230.
BACKGROUND/AIMS: Optimal bowel preparation is essential for successful screening or for surveillance colonoscopy (SC). Inadequate bowel preparation is associated with older age, the male gender, and the presence of certain comorbidities. However, the association between patients' functional status and bowel preparation quality has not been studied. We prospectively examined the relationship between functional status, namely, the ability to perform activities of daily living (ADLs) and ambulate, and the quality of bowel preparation in elderly patients undergoing SC.
Before undergoing SC, 88 elderly patients were surveyed regarding their functional status, specifically regarding their ability to perform ADLs and ambulate a quarter of a mile. Gastroenterologists then determined the quality of the bowel preparation, which was classified as either adequate or inadequate. Then, the frequency of inadequate bowel preparation in patients who did or did not experience difficulty performing ADLs and ambulating was calculated.
Difficulty ambulating (unadjusted odds ratio [OR], 4.83; p<0.001), difficulty performing ADLs (OR, 2.93; p=0.001), and history of diabetes (OR, 2.88; p=0.007) were significant univariate predictors of inadequate bowel preparation. After adjusting for the above variables, only difficulty ambulating (adjusted OR, 5.78; p=0.004) was an independent predictor of inadequate bowel preparation.
Difficulty with ambulation is a strong predictor of inadequate bowel preparation in elderly patients undergoing SC.
背景/目的:最佳的肠道准备对于成功进行筛查或监测结肠镜检查(SC)至关重要。肠道准备不充分与高龄、男性以及某些合并症的存在有关。然而,患者的功能状态与肠道准备质量之间的关联尚未得到研究。我们前瞻性地研究了功能状态,即进行日常生活活动(ADL)和行走的能力,与接受SC的老年患者肠道准备质量之间的关系。
在接受SC之前,对88名老年患者进行了关于其功能状态的调查,特别是关于他们进行ADL和行走四分之一英里的能力。然后,胃肠病学家确定肠道准备的质量,分为充分或不充分。接着,计算了在进行ADL和行走有困难或没有困难的患者中肠道准备不充分的频率。
行走困难(未调整优势比[OR],4.83;p<0.001)、进行ADL困难(OR,2.93;p=0.001)和糖尿病史(OR,2.88;p=0.007)是肠道准备不充分的显著单因素预测指标。在对上述变量进行调整后,只有行走困难(调整后OR,5.78;p=0.004)是肠道准备不充分的独立预测指标。
行走困难是接受SC的老年患者肠道准备不充分的有力预测指标。