Abstract
Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.
| Original language | English |
|---|---|
| Pages (from-to) | 501-506 |
| Number of pages | 6 |
| Journal | Clinical Gastroenterology and Hepatology |
| Volume | 10 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2012 |
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Keywords
- Colon Cancer Screening
- Laxative
- Polyethylene Glycol
- Polyp Detection
ASJC Scopus subject areas
- Gastroenterology
- Hepatology
Cite this
A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy. / Hassan, Cesare; Fuccio, Lorenzo; Bruno, Mario; Pagano, Nico; Spada, Cristiano; Carrara, Silvia; Giordanino, Chiara; Rondonotti, Emanuele; Curcio, Gabriele; Dulbecco, Pietro; Fabbri, Carlo; Della Casa, Domenico; Maiero, Stefania; Simone, Adriana; Iacopini, Federico; Feliciangeli, Giuseppe; Manes, Gianpiero; Rinaldi, Antonio; Zullo, Angelo; Rogai, Francesca; Repici, Alessandro.
In: Clinical Gastroenterology and Hepatology, Vol. 10, No. 5, 05.2012, p. 501-506.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy
AU - Hassan, Cesare
AU - Fuccio, Lorenzo
AU - Bruno, Mario
AU - Pagano, Nico
AU - Spada, Cristiano
AU - Carrara, Silvia
AU - Giordanino, Chiara
AU - Rondonotti, Emanuele
AU - Curcio, Gabriele
AU - Dulbecco, Pietro
AU - Fabbri, Carlo
AU - Della Casa, Domenico
AU - Maiero, Stefania
AU - Simone, Adriana
AU - Iacopini, Federico
AU - Feliciangeli, Giuseppe
AU - Manes, Gianpiero
AU - Rinaldi, Antonio
AU - Zullo, Angelo
AU - Rogai, Francesca
AU - Repici, Alessandro
PY - 2012/5
Y1 - 2012/5
N2 - Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.
AB - Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.
KW - Colon Cancer Screening
KW - Laxative
KW - Polyethylene Glycol
KW - Polyp Detection
UR - http://www.scopus.com/inward/record.url?scp=84859870168&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84859870168&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2011.12.037
DO - 10.1016/j.cgh.2011.12.037
M3 - Article
C2 - 22239959
AN - SCOPUS:84859870168
VL - 10
SP - 501
EP - 506
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
IS - 5
ER -