USC Keck School of Medicine, Los Angeles, California.
Department of Surgery, USC Keck School of Medicine, Los Angeles, California.
J Surg Res. 2024 Oct;302:697-705. doi: 10.1016/j.jss.2024.07.058. Epub 2024 Aug 29.
Studies show that mechanical bowel preparation (MBP) plus oral antibiotics (OAs) is associated with decreased rates of postoperative complications after elective colorectal surgery. However, there is a lack of literature regarding patient compliance with bowel preparation (BP).
Patients undergoing elective colorectal surgeryfrom April 2020 to March 2022 at a tertiary care academic hospital (TCAH) and safety net hospital (SNH) were administered a BP compliance survey. Patients were compared on the basis of hospital setting and completeness of BP using student's t-tests and Fisher's exact tests, as appropriate.
105 patients were included as follows: 55 from the TCAH and 50 from the SNH. The median age was 59. 45.7% were female. TCAH had a higher proportion of White patients (36.4% versus 0%), while the SNH had a higher proportion of Hispanic patients (78% versus 10.9%). Most patients at the TCAH reported English as their primary language (80% versus 28%), while most patients at the SNH spoke primarily Spanish (60% versus 7.3%). In total, 88.6% (n = 93) of patients completed the MBP- 87.3% at the TCAH and 90% at the SNH (P = 0.764). 86.7% took all three doses of OA. Compared to the SNH patients, a smaller percentage of TCAH patients took all doses of OA (78.2% versus 96%, P = 0.009). Overall, 45.7% of patients reported adverse symptoms with BP. The only patient factor associated with a complete bowel preparation was SNH setting (P = 0.024).
Overall, almost 90% of patients were compliant with both MBP and OA. Compliance with OA among patients at the TCAH was significantly lower compared to patients at the SNH. An SNH setting was associated with completing a BP. Individual compliance is likely impacted by both institutional practices and patient factors.
研究表明，机械肠道准备（MBP）加口服抗生素（OAs）可降低择期结直肠手术后术后并发症的发生率。然而，关于患者对肠道准备（BP）的依从性的文献却很少。
2020 年 4 月至 2022 年 3 月，在一家三级保健学术医院（TCAH）和安全网医院（SNH）接受择期结直肠手术的患者接受了 BP 依从性调查。根据医院环境和 BP 的完整性，使用学生 t 检验和 Fisher 精确检验进行比较，具体取决于情况。
共纳入 105 例患者，其中 TCAH 55 例，SNH 50 例。中位年龄为 59 岁，45.7%为女性。TCAH 白人患者比例较高（36.4%比 0%），而 SNH 西班牙裔患者比例较高（78%比 10.9%）。TCAH 大多数患者报告英语为其主要语言（80%比 28%），而 SNH 大多数患者主要讲西班牙语（60%比 7.3%）。总的来说，88.6%（n=93）的患者完成了 MBP-87.3%在 TCAH 和 90%在 SNH（P=0.764）。86.7%的患者服用了所有三种剂量的 OA。与 SNH 患者相比，TCAH 患者服用所有 OA 剂量的比例较小（78.2%比 96%，P=0.009）。总的来说，45.7%的患者报告 BP 有不良反应症状。唯一与完整肠道准备相关的患者因素是 SNH 环境（P=0.024）。
总体而言，近 90%的患者 MBP 和 OA 均符合要求。与 SNH 患者相比，TCAH 患者服用 OA 的依从性明显较低。SNH 环境与 BP 的完成相关。个体依从性可能受到机构实践和患者因素的共同影响。
