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Colonoscopy quality in community hospitals and nonhospital facilities in Korea

Authors :
Jae Gon Lee
Dong Soo Han
Young-Eun Joo
Dae-Seong Myung
Dong Il Park
Seul Ki Kim
Yunho Jung
Won Hyun Lee
Eun Soo Kim
Joon Seok Yoon
Chang Soo Eun
Source :
The Korean Journal of Internal Medicine, Vol 36, Iss Suppl 1, Pp S35-S43 (2021)
Publication Year :
2021
Publisher :
The Korean Association of Internal Medicine, 2021.

Abstract

Background/Aims High-quality colonoscopy is essential to reduce colorectal cancer-related deaths. Little is known about colonoscopy quality in non-academic practice settings. We aimed to evaluate the quality of colonoscopies performed in community hospitals and nonhospital facilities. Methods Colonoscopy data were collected from patients referred to six tertiary care centers after receiving colonoscopies at community hospitals and nonhospital facilities. Based on their photographs, we measured quality indicators including cecal intubation rate, withdrawal time, adequacy of bowel preparation, and number of polyps. Results Data from a total of 1,064 colonoscopies were analyzed. The overall cecal intubation rate was 93.1%. The median withdrawal time was 8.3 minutes, but 31.3% of colonoscopies were withdrawn within 6 minutes. Community hospitals had longer withdrawal time and more polyps than nonhospital facilities (median withdrawal time: 9.9 minutes vs. 7.5 minutes, p < 0.001; mean number of polyps: 3.1 vs. 2.3, p = 0.001). Board-certified endoscopists had a higher rate of cecal intubation than non-board-certified endoscopists (93.2% vs. 85.2%, p = 0.006). A total of 819 follow-up colonoscopies were performed at referral centers with a median interval of 28 days. In total, 2,546 polyps were detected at baseline, and 1,088 were newly identified (polyp miss rate, 29.9%). Multivariable analysis revealed that older age (odds ratio [OR], 1.032; 95% confidence interval [CI], 1.020 to 1.044) and male sex (OR, 1.719; 95% CI, 1.281 to 2.308) were associated with increased risk of missed polyps. Conclusions The quality of colonoscopies performed in community hospitals and nonhospital facilities was suboptimal. Systematic reporting, auditing, and feedback are needed for quality improvement.

Details

Language :
English
ISSN :
12263303 and 20056648
Volume :
36
Issue :
Suppl 1
Database :
Directory of Open Access Journals
Journal :
The Korean Journal of Internal Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.49c3b7074de24e1b8d5ee06f54a5dd32
Document Type :
article
Full Text :
https://doi.org/10.3904/kjim.2019.117