Analysis Of Influence Factors For Bowel Preparation Quality Before Colonoscopy And Establishment Of Prediction Model

Objective: The quality of bowel preparation directly affects the safety and effectiveness of colonoscopy.The purpose of this study is to understand the current status of bowel preparation in outpatient colonoscopy patients,to explore related risk factors for inadequate bowel preparation,and to construct a simple and effective predictive model of bowel preparation quality.Methods: The enrolled patients were outpatients who underwent colonoscopy at the Endoscopic Center of the General Hospital of Eastern Theater of the PLA from July 2019 to December 2019.The researchers completed the baseline and clinical data collection through questionnaires.The Boston bowel preparation score scale was used to score bowel cleanliness,and the evaluation results were classified as adequate or inadequate,that is,success and failure,and were grouped according to the quality of bowel preparation.For comparison between groups,the χ2 test or the independent sample T test was used.The variables with P <0.1 were included in the binary logistic regression for multivariate analysis to determine independent risk factors for bowel preparation failure.We used the regression coefficient of each factor to assign the risk score and established a predictiive model.The receiver operating characteristic curve analysis was used to verify the validity of the prediction model.Results: A total of 400 outpatients undergoing colonoscopy were included,of which 96 patients(24%)were inadequately prepared for bowel;a univariate analysis found that: age> 50 years(P = 0.025),male(P = 0.032),low education(P = 0.035),diabetes(P = 0.004),constipation(P = 0.021),high-fiber diet(P = 0.025),and water consumption <2L(P = 0.022)were relevant factors for bowel preparation failure;Multivariate logistic regression was used to analyze the above relevant factors.The results showed that: male(OR = 2.496,95% CI: 1.429-4.362,P = 0.001),low education(OR =1.869,95%CI: 1.128-3.099,P=0.015),constipation(OR=2.520,95%CI: 1.417-4.479,P = 0.002),diabetes(OR= 2.504,95%CI: 1.119-5.604,P = 0.026),high-fiber diet(OR = 1.956,95%CI: 1.187-3.223,P = 0.009),and water consumption <2L(OR= 2.434,95%CI: 1.333-4.443,P = 0.004)were independent risk factors for bowel preparation failure.The area under the ROC curve of the model group was 0.714,which had medium accuracy.When the cut-off value was 3.5 points,the sensitivity was 87.5% and the specificity was 48.0%.Conclusion: we found that: male,low education,constipation,diabetes,high fiber diet,and low water intake were independent risk factors for bowel preparation failure in outpatient colonoscopy screening,and used these factors to establish a simple and effective predictive model of bowel preparation quality to provide clinical staff with a basis for decision making.