The impact of bowel cleansing on follow-up recommendations in average-risk patients with a normal colonoscopy.
The impact of bowel cleansing on follow-up recommendations in average-risk patients with a normal colonoscopy.
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DOI：
10.1038/ajg.2013.243
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发表时间：
2014-02
影响因子：
9.8
通讯作者：
Schoenfeld, Philip
中科院分区：
文献类型：
--
作者：
Menees, Stacy B.;Elliott, Eric;Govani, Shail;Anastassiades, Constantinos;Judd, Stephanie;Urganus, Annette;Boyce, Suzanna;Schoenfeld, Philip
建议一般风险患者在正常筛查结肠镜检查后 10 年内再次进行结肠镜检查，美国胃肠病学协会 (AGA)、美国胃肠病学会 (ACG) 和美国胃肠内窥镜检查协会 (ASGE) 已提议将其作为质量衡量标准。然而，关于遵守这一建议或可能提高遵守率的因素的定量数据很少。我们的研究量化了对这一建议的遵守情况以及次优肠道准备对遵守情况的影响。在这项回顾性数据库研究中，对年龄≥50岁且结肠镜筛查正常的平均风险个体的内窥镜检查报告进行了审查。使用阿伦奇克量表将结肠清洁的质量记录为优秀、良好、一般或差。主要结果测量是肠道准备的质量和重复结肠镜检查时间的建议。如果在优秀、良好或一般准备后记录了 10 年随访，或者在准备不佳后建议≤1 年随访，则认为建议与指南一致。在 1,387 名符合条件的患者中，有 332 名 (23.9%) 受试者的后续结肠镜检查建议与指南不一致。根据肠道准备质量，15.3% 的优秀/良好、75% 的一般和 31.6% 的不良肠道准备被分配了与指南不一致的建议 (P < 0.001)。与准备良好/良好的患者相比，一般（比值比 = 18.0；95% 置信区间 12.0–28.0）的患者更有可能提出与指南不一致的建议。超过 20% 的患者在正常结肠镜检查后每隔 10 年提出的建议与指南不一致。尽量减少“公平”肠道准备可能是提高对这些建议的依从性的有益干预措施。
Repeat colonoscopy in 10 years after a normal screening colonoscopy is recommended in an average-risk patient, and it has been proposed by American Gastroenterological Association (AGA), American College of Gastroenterology (ACG), and American Society for Gastrointestinal Endoscopy (ASGE) as a quality measure. However, there are little quantitative data about adherence to this recommendation or factors that may improve adherence. Our study quantifies adherence to this recommendation and the impact of suboptimal bowel preparation on adherence. In this retrospective database study, endoscopy reports of average-risk individuals ≥50 years old with a normal screening colonoscopy were reviewed. Quality of colon cleansing was recorded using the Aronchick scale as excellent, good, fair, or poor. Main outcome measurements were quality of bowel preparation and recommendation for timing of repeat colonoscopy. Recommendations were considered consistent with guidelines if 10-year follow-up was documented after excellent, good, or fair prep or if ≤1-year follow-up was recommended after poor prep. Among 1,387 eligible patients, recommendations for follow-up colonoscopy inconsistent with guidelines were seen in 332 (23.9%) subjects. By bowel preparation quality, 15.3% of excellent/ good, 75% of fair, and 31.6% of poor bowel preparations were assigned recommendations inconsistent with guidelines (P < 0.001). Patients with fair (odds ratio = 18.0; 95% confidence interval 12.0–28.0) were more likely to have recommendations inconsistent with guidelines compared with patients with excellent/good preps. Recommendations inconsistent with guidelines for 10-year intervals after a normal colonoscopy occurred in >20% of patients. Minimizing “fair” bowel preparations may be a helpful intervention to improve adherence to these recommendations.
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影响因子：
4.3
作者：
Parra-Blanco, Adolfo;Nicolas-Perez, David;Quintero, Enrique
通讯作者：
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发表时间：
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