Risk factors for inadequate colonoscopy bowel preparations in African Americans and whites at an urban medical center.
Risk factors for inadequate colonoscopy bowel preparations in African Americans and whites at an urban medical center.
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DOI：
10.1097/smj.0000000000000087
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发表时间：
2014-04
影响因子：
1.1
通讯作者：
Kupfer SS
中科院分区：
文献类型：
--
作者：
Appannagari A;Mangla S;Liao C;Reddy KG;Kupfer SS
肠道准备不佳导致结肠直肠癌筛查的检查不足和监测间隔缩短。以前关于准备不足的风险因素的研究没有包括大量的非洲裔美国人。我们的目的是在一个大的、种族多样的患者人群中确定初始和随访结肠镜检查时肠道准备不足的患病率。回顾性分析了1年期间进行的结肠镜检查。包括年龄，性别，种族和开始时间的因素进行了记录。患者的邮政编码与人口普查数据相关联，以估计教育和收入。对于肠道准备不充分的检查，我们收集了有关建议和后续程序准备质量的数据。我们纳入了3741例患者（40.2%为非洲裔美国人）。其中，66.9%的患者进行了充分的肠道准备，33.1%的患者肠道准备不足。非裔美国人的准备不足的患病率最高，为43.0%。非裔美国人的种族是肠道准备不足的预测因子，尽管控制了教育和收入。年龄、男性和手术发生在12 PM之后也是准备不足的风险因素。在内窥镜检查报告中收到具体的准备说明不会影响随访检查的准备质量。我们的研究发现，肠道准备不足的比例很高（33.1%），非洲裔美国人是肠道准备不足的独立风险因素。我们验证了先前报告的风险因素，包括年龄，男性性别和后期手术时间。最后，我们注意到随访检查准备不足的比例很高。提高结肠镜检查肠道准备的质量对于预防结直肠癌非常重要，特别是在非洲裔美国人等高危人群中。
Poor bowel preparation leads to inadequate examinations and shorter surveillance intervals for colorectal cancer screening. Previous studies regarding risk factors for inadequate preparation have not included large numbers of African Americans. Our aim was to determine the prevalence of inadequate bowel preparation on initial and follow-up colonoscopy in a large, racially diverse patient population. Colonoscopies performed during a 1-year period were analyzed retrospectively. Factors including age, sex, race, and start time were recorded. Patient ZIPcodes were linked to census data to estimate education and income. For examinations with inadequate bowel preparations, we collected data on recommendations and the preparation quality of follow-up procedures. We included 3741 patients (40.2% African American). Of these, 66.9% had adequate bowel preparation and 33.1% had inadequate bowel preparation. African Americans had the highest prevalence of inadequate preparations at 43.0%. African American race was a predictor of inadequate bowel preparation, despite controlling for education and income. Age, male sex, and procedure taking place after 12 PM also were risk factors for inadequate preparation. Receipt of specific preparation instructions on the endoscopy report did not affect preparation quality on follow-up examination. Our study found a high rate (33.1%) of inadequate bowel preparations, and African American race was found to be an independent risk factor for inadequate preparation. We validated previously reported risk factors including age, male sex, and later procedure time. Finally, we noted high rates of inadequate preparation on follow-up examinations. Improving the quality of colonoscopy bowel preparation is important for colorectal cancer prevention, especially in high-risk populations such as African Americans.