The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK
The national colonoscopy audit: a nationwide assessment of the quality and safety of colonoscopy in the UK
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DOI：
10.1136/gutjnl-2011-301848
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发表时间：
2013-02-01
期刊：
影响因子：
24.5
通讯作者：
Swarbrick, Edwin T.
中科院分区：
文献类型：
--
作者：
Gavin, Daniel R.;Valori, Roland M.;Swarbrick, Edwin T.
目的对在英国进行的为期2周的结肠镜检查进行全面审计。设计多中心调查。纳入2011年2月28日至2011年3月11日期间在参与的国家卫生服务医院进行的所有成人（>= 16岁）结肠镜检查。结果302个单位共收集结肠镜检查20 085例，结肠镜检查人员2681例。一项验证工作表明，在全国执行的所有程序中，收集了94%以上的数据。未调整盲肠插管率（CIR）为92.3%。当考虑无法通过的狭窄和肠道准备不良时，CIR为95.8%。息肉检出率为32.1%。较大息肉（>= 10mm直径）检出率为11.7%。92.3%的切除息肉恢复。90.2%的手术达到了患者可接受的舒适水平。共报告8例穿孔和52例显著出血。8名患者因并发症接受了手术。结论：这是第一次对结肠镜检查的全国审计，成功地捕获了全国在特定时期内进行的大多数成人结肠镜检查。数据证实，自七年前的最后一项研究报告以来，英国结肠镜检查的表现有了显着改善（CIR为76.9%），并且表现高于要求的国家标准。
Objective To perform a comprehensive audit of all colonoscopy undertaken in the UK over a 2-week period.Design Multi-centre survey. All adult (>= 16 years of age) colonoscopies that took place in participating National Health Service hospitals between 28 February 2011 and 11 March 2011 were included.Results Data on 20 085 colonoscopies and 2681 colonoscopists were collected from 302 units. A validation exercise indicated that data were collected on over 94% of all procedures performed nationally. The unadjusted caecal intubation rate (CIR) was 92.3%. When adjusted for impassable strictures and poor bowel preparation the CIR was 95.8%. The polyp detection rate was 32.1%. The polyp detection rate for larger polyps (>= 10mm diameter) was 11.7%. 92.3% of resected polyps were retrieved. 90.2% of procedures achieved acceptable levels of patient comfort. A total of eight perforations and 52 significant haemorrhages were reported. Eight patients underwent surgery as a consequence of a complication.Conclusions This is the first national audit of colonoscopy that has successfully captured the majority of adult colonoscopies performed across an entire nation during a defined time period. The data confirm that there has been a significant improvement in the performance of colonoscopy in the UK since the last study reported seven years ago (CIR 76.9%) and that performance is above the required national standards.