Back to Search
Start Over
Risk factors for inadequate bowel preparation: a validated predictive score.
- Source :
- Endoscopy; 2017, Vol. 49 Issue 6, p536-543, 8p
- Publication Year :
- 2017
-
Abstract
- Background and study aim Inadequate bowel cleansing negatively affects the efficiency of colonoscopy in routine clinical practice. The aim of this study was to design and validate a predictive model for inadequate bowel cleanliness. Patients and methods The model was built from 667 consecutive outpatients (development cohort) who were prospectively scheduled for colonoscopy between June and September 2014. The validation cohort included 409 outpatients who underwent colonoscopy between October and December 2014. Cleansing was evaluated using the Boston Bowel Preparation Scale (BBPS). Bowel preparation was administered on the same day as the examination. Results In the development cohort, BBPS was adequate in 541 patients (81.1 %). At multivariate analysis, antidepressants (odds ratio [OR] 4.25, 95 % confidence interval [CI] 1.91 - 9.47), co-morbidity (OR 3.35, 95 %CI 2.16 - 5.18), constipation (OR 2.09, 95 %CI 1.29 - 3.40), and abdominal/pelvic surgery (OR 1.60, 95 %CI 1.03 - 2.47) were independent predictors for inadequate cleansing. The model built with these variables showed an area under the curve of 0.72 in the development cohort and 0.70 in the validation cohort. A cutoff of 1.225 predicted inadequate bowel preparation with a sensitivity, specificity, positive predictive value, and negative predictive value of 60.3 % (95 %CI 51.6 - 68.4), 75.4 % (95 %CI 71.6 - 78.9), 36.4 % (95 %CI 30.1 - 43.1), and 89.1 % (95 %CI 85.9 - 91.6) in the development cohort, and 50.0 % (95 %CI 38.1 - 61.9), 80.0 % (95 %CI 75.3 - 84.2), 35.7 % (95 %CI 26.4 - 45.6), and 87.9 % (95 %CI 83.7 - 91.3) in the validation cohort. Conclusion A simple score may assist the clinician in predicting which patients are at high risk of inadequate bowel cleanliness. This may guide changes in bowel preparation strategy accordingly. [ABSTRACT FROM AUTHOR]
- Subjects :
- BOWEL preparation (Procedure)
COLONOSCOPY
DISEASE risk factors
ABDOMINAL surgery
ANTIDEPRESSANTS
PELVIC surgery
LAXATIVES
COLON tumors
COMPARATIVE studies
CONSTIPATION
RESEARCH methodology
MEDICAL cooperation
RECTUM tumors
RESEARCH
COMORBIDITY
EVALUATION research
PREDICTIVE tests
RECEIVER operating characteristic curves
THERAPEUTICS
Subjects
Details
- Language :
- English
- ISSN :
- 0013726X
- Volume :
- 49
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 123313131
- Full Text :
- https://doi.org/10.1055/s-0043-101683