The impact of poor bowel preparation on colonoscopy: a prospective single centre study of 10 571 colonoscopies
The impact of poor bowel preparation on colonoscopy: a prospective single centre study of 10 571 colonoscopies
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DOI：
10.1111/j.1463-1318.2007.01220.x
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发表时间：
2007-10-01
影响因子：
3.4
通讯作者：
Diament, R. H.
中科院分区：
文献类型：
--
作者：
Hendry, P. O.;Jenkins, J. T.;Diament, R. H.
目的结肠镜检查被认为是评价结肠最敏感的方法。不充分的准备降低敏感性，并对个别患者和Heath Service.Method的不良影响有关的充分肠道准备和结肠镜检查完成率的数据前瞻性收集在一个单一的中心在1996年1月至2005年1月之间进行的所有结肠镜检查。此外，进一步调查的策略，在不完整的examination.Results的事件进行了评估，共10 571结肠镜检查，并确定在这些情况下，1788（16.9%）肠道准备不佳。准备满意者完成率为67.5%。在准备不充分的患者中，36%的结肠镜检查完成。准备不充分更可能导致检查不完整[OR = 3.76（95%CI，3.38-4.18），P = 0.0005]。住院患者更可能准备不良[OR = 3.54（95%CI 3.14-3.96），P = 0.0005]。即使准备充分，住院完成率也明显较低[OR = 1.78（95%CI，3.14-3.96），P = 0.0005）。进一步542诊断程序进行了准备不足组，额外的101磅950（e149 459）的expenditure.Conclusion本研究支持的观点，住院病人的票价很糟糕。部分原因是准备不足的比例较高;然而，即使准备充分，完成率也有所下降。失败的调查和延长住院时间增加了成本。结肠镜检查完成率需要提高，特别要注意住院患者。
Objective Colonoscopy is regarded as the most sensitive method of evaluating the colon. Inadequate preparation reduces sensitivity and has adverse implications for individual patients and the Heath Service.Method Data concerning the adequacy of bowel preparation and colonoscopy completion rates were prospectively collected on all colonoscopies performed in a single centre between January 1996 and January 2005. In addition, the strategy of further investigation in the event of incomplete examination was assessed.Results A total of 10 571 colonoscopies were assessed and poor bowel preparation was identified in 1788 of these cases (16.9%). The completion rate was 67.5% in those with satisfactory preparation. In patients with poor preparation, 36% of colonoscopies were complete. Incomplete examination was more likely with poor preparation [OR = 3.76 (95% CI, 3.38-4.18), P = 0.0005]. Poor preparation was more likely for inpatients [OR = 3.54 (95% CI 3.14-3.96), P = 0.0005]. Even with satisfactory preparation, inpatient completion rates were significantly less [OR = 1.78 (95% CI, 3.14-3.96), P = 0.0005). A further 542 diagnostic procedures were undertaken in the poor preparation group, an additional 101 pound 950 (e149 459) in expenditure.Conclusion This study supports the view that inpatients fare badly. This is partly explained by higher rates of poor preparation; however, completion rates were reduced even with adequate preparation. Failed investigation and prolonged hospital stay increase cost. Colonoscopy completion rates need to be improved with particular attention to inpatients.