Asgari Alireza, Ziamanesh Fateme, Aliasgari Ali, Sohrabpour Amir Ali
Digestive Disease Research Institute Tehran University of Medical Sciences Tehran Iran.
Tehran Gastroenterology and Hepatology Centre (Masoud Clinic) Tehran Iran.
JGH Open. 2024 Aug 20;8(8):e13116. doi: 10.1002/jgh3.13116. eCollection 2024 Aug.
Adequate bowel preparation is necessary for optimal colonoscopy. Inadequate bowel preparation results in increased costs and imprecise colonoscopy results. This study aims to determine the incidence and risk factors of inadequate bowel preparation.
In this study, 604 consecutive patients were observed prospectively who underwent colonoscopy examination. The patient's clinical and demographic data were obtained on the day of the procedure. Bowel preparation was evaluated by Boston Bowel Preparation Scale (BBPS) and was divided into two groups; adequate and inadequate. Univariate and multivariate analyses were performed.
Inadequate bowel preparation incidence was 17.9%. In the univariate analysis, education level ( value = 0.009), body mass index ( value = 0.03), admission type ( value = 0.038), previous history of colonoscopy ( value = 0.03), color and consistency of the last feces ( value = 0.03), diabetes ( value = 0.004), and smoking ( value = 0.03) were significantly related with the incidence of inadequate bowel preparation. While ischemic heart disease (IHD) decreased the level of inadequate bowel preparation ( value = 0.047). Multivariate analysis showed that diabetes mellitus (odds ratio [OR] = 2.18), smoking (OR = 2.10), inpatient status of admission type (OR = 3.32), last stool that was non-watery (OR = 1.60), and ischemic heart disease (OR = 0.032) were independent factors associated with inadequate bowel preparation.
Diabetic patients, smokers, inpatients and who defecated a non-watery and colory stool as the last defecation are at risk of inadequate bowel preparation and need more potent regimens. It is important to inform patients about preventable factors that affect bowel preparation to improve their preparation outcomes.
充分的肠道准备对于优化结肠镜检查至关重要。肠道准备不充分会导致成本增加以及结肠镜检查结果不准确。本研究旨在确定肠道准备不充分的发生率及危险因素。
在本研究中，对604例连续接受结肠镜检查的患者进行前瞻性观察。在检查当天获取患者的临床和人口统计学数据。通过波士顿肠道准备量表（BBPS）评估肠道准备情况，并分为两组：充分和不充分。进行单因素和多因素分析。
肠道准备不充分的发生率为17.9%。在单因素分析中，教育水平（P值 = 0.009）、体重指数（P值 = 0.03）、入院类型（P值 = 0.038）、既往结肠镜检查史（P值 = 0.03）、最后粪便的颜色和质地（P值 = 0.03）、糖尿病（P值 = 0.004）以及吸烟（P值 = 0.03）与肠道准备不充分的发生率显著相关。而缺血性心脏病（IHD）降低了肠道准备不充分的水平（P值 = 0.047）。多因素分析显示，糖尿病（比值比[OR] = 2.18）、吸烟（OR = 2.10）、入院类型的住院状态（OR = 3.32）、最后一次粪便非水样（OR = 1.60）以及缺血性心脏病（OR = 0.032）是与肠道准备不充分相关的独立因素。
糖尿病患者、吸烟者、住院患者以及最后一次排便为非水样且有颜色的粪便的患者存在肠道准备不充分的风险，需要更有效的方案。告知患者影响肠道准备的可预防因素以改善其准备结果很重要。
