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FACTORS ASSOCIATED WITH SEDATION USE IN DIAGNOSTIC AND SCREENING PATIENTS ≥50 YEARS OF AGE: OBSERVATIONS FROM THE EUROPEAN COLONOSCOPY QUALITY INVESTIGATION (ECQI) QUESTIONNAIRE
18 March 2019 (online)
To assess the factors associated with sedation use in diagnostic and screening patients ≥50 years of age using questionnaire responses from across Europe.
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 (n = 6445).
All screening and diagnostic colonoscopies in patients aged ≥50 years were identified in our dataset (n = 3365). Stepwise multivariable logistic regression analysis was conducted to determine the main factors associated with sedation use. Analysis was performed on the following variables: age in 10-year categories; body mass index (BMI) categories; gender; inpatient status; reason for procedure; time of day colonoscopy performed; previous total colonoscopy in last 5 years; Boston Bowel Preparation Score (BBPS) ≥6; retraction time categories; chromoendoscopy used; high-definition equipment used; assistive technology used; intended endpoint; and intended endpoint reached.
There were 1394 procedures where the results of all selected variables were known provided by 59 practitioners from 38 institutions: 71.0% of procedures used sedation. In order, the most associated variables were:
Use of high-definition equipment (76.3% vs. 55.5%, p < 0.0001).
Use of assistive technology (59.0% vs. 72.8%, p < 0.0001).
Female gender (78.8% vs. 62.2% male, p < 0.0001).
Longer retraction time (83.9% > 10 minutes vs. 65.1% 6 – 10 minutes and 66.7% < 6 minutes, p < 0.0001).
Use of chromoendoscopy (76.3% vs. 69.5%, p = 0.0051).
Younger patient age (78.0% 50 – 59 years vs. 67.6% 60 – 69, 68.1% 70 – 79, 69.4% ≥80, p < 0.0001).
Inpatient status (84.0% vs. 68.7% outpatient, p < 0.0001).
The use of sedation appears to be more associated with factors related to the equipment/techniques used during colonoscopy than patient characteristics.