Endoscopy 2019; 51(04): S56
DOI: 10.1055/s-0039-1681335
ESGE Days 2019 oral presentations
Friday, April 5, 2019 14:30 – 16:30: Colon cleansing 2 Club D
Georg Thieme Verlag KG Stuttgart · New York

FACTORS ASSOCIATED WITH ADEQUATE BOWEL PREPARATION: OBSERVATIONS FROM THE EUROPEAN COLONOSCOPY QUALITY INVESTIGATION (ECQI) QUESTIONNAIRE

P Amaro
1   Coimbra University Hospital, Coimbra, Portugal
,
A Agrawal
2   Doncaster Royal Infirmary, Doncaster, United Kingdom
,
L Brink
3   Herlev Hospital, Herlev, Denmark
,
W Fischbach
4   Gastroenterologie und Innere Medizin, Aschaffenburg, Germany
,
M Hünger
5   Private Practice for Internal Medicine, Würzburg, Germany
,
R Jover
6   Hospital General Universitario de Alicante, Alicante, Spain
,
U Kinnunen
7   Tampere University Hospital, Tampere, Finland
,
A Koulaouzidis
8   The Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
A Ono
9   Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
,
Á Patai
10   Markusovszky University Teaching Hospital, Szombathely, Hungary
,
S Pecere
11   Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy
12   Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
L Petruzziello
11   Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy
12   Università Cattolica del Sacro Cuore, Centre for Endoscopic Research Therapeutics and Training – CERTT, Rome, Italy
,
E Toth
13   Skåne University Hospital, Lund University, Malmö, Sweden
,
JF Riemann
14   Director em. Klinikum Ludwigshafen, Chairman, LebensBlicke Foundation for the Prevention of Colorectal Cancer, Ludwigshafen, Germany
,
B Amlani
15   Norgine, Harefield, Middlesex, United Kingdom
,
C Spada
16   Fondazione Poliambulanza, Brescia, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

To investigate the factors associated with adequate bowel preparation using questionnaire responses from across Europe.

Methods:

The development of the procedure questionnaire, by the European Colonoscopy Quality Investigation (ECQI) Group, has been previously described in posters presented at UEGW, 2015 and 2016. Data collection is an ongoing process. We analysed data collected between 2/6/16 and 30/4/18.

A stepwise multivariable logistic regression analysis was performed to investigate which factors are associated with achievement of adequate bowel preparation, defined as a Boston Bowel Preparation Scale (BBPS) score ≥6. Analysis was performed on the following variables: age over or under 50; gender; body mass index (BMI) categories; inpatient/outpatient status; reason for procedure; use of bowel preparation; whether the patient followed instructions; proportion of bowel preparation consumed; total volume of fluid consumed; time period since last dose of bowel preparation; dosing regimen; time of day colonoscopy was performed.

Results:

Data were collected on 6455 procedures, of which whether bowel preparation was adequate (BBPS≥6) or not could be determined in 6236. Of these, there were 2884 procedures where the results of all selected variables were known: adequate bowel preparation was achieved in 86.96% of these procedures.

The first five variables most associated with adequate bowel clearance were, in order:

  1. Patient following instructions (89.1% vs. 54.3%, p < 0.0001).

  2. Split-dosing or same-day regimen (89.5% split-dosing and 90.8% same-day vs. 77.9% evening, p = 0.004).

  3. Outpatient status (88.4% vs. 77.3% inpatient, p < 0.0001).

  4. Age < 50 years (93.3% vs. 85.3% > 50 years, p < 0.0001).

  5. Lower time period between procedure and last intake of bowel preparation (mean 6.1 hours vs. 8.0 hours in those with inadequate bowel preparation, p = 0.0030).

Conclusions:

Patients following instructions is the most important factor associated with achieving adequate bowel clearance followed by using a split-dosing or same-day regimen.