Analysis Of Influence Factors For Bowel Preparation Quality Of Colonoscopy

Background and ObjectiveColonoscopy is the directest and the most effective way to detect the colorectal disease,while the bowel preparation quality is one of the most important indicators assessing colonoscopy quality.The objective of our research was to analyze the relevant independent risk factors of inadequate bowel preparation in patients undergoing colonoscopy and whether the influence of these independent risk factors on different bowel segments’ cleansing quality was significant.Methods394 patients undergoing colonoscopy in a tertiary A hospital in Shenzhen from November 2021 to November 2022 were enrolled according to the inclusion and exclusion criteria.Patients’ and colonoscopy’s relevant information were prospectively collected and bowel preparation quality was assessed by Boston Bowel Preparation Scale(BBPS).The risk factors with P<0.05 were incorporated in the logistic regression for multivariate analysis to screen out the independent risk factors.χ2 test was used to analyze if above variables influenced different bowel segments’ cleansing quality significantly.Results1.Inadequate bowel preparation was seen in 20.8%of cases,the adenoma detection rate and the polyp detection rate(PDR and ADR)is 20.3%.The mean BBPS in right colon and transverse colon and left colon is 2.17±0.036,2.40±0.034,2.41±0.032.2.Independant factors associated with inadequate bowel preparation according to Logistic regression analysis:not taking simethicone(OR=2.236),<75%consumption of PEG(OR=3.337),patients with Bristol stool types 1 and 2(OR=3.359),the last defecation consisting of solid composition(OR=6.664),the time interval between bowel preparation and colonoscopy>6h(OR=2.483)(all P<0.05).3.The effect difference of risk factors on different bowel segments’ bowel preparation quality:The bowel preparation score of transverse colon and right colon and the whole bowel segment in simethicone group was higher than without simethicone group(P<0.05),while there was no difference in left colon.The bowel preparation score of left colon and the whole bowel segment in>75%consumption of PEG group was higher than<75%consumption of PEG group,while there was no difference in transverse and right colon.The bowel preparation score of left colon and transverse colon and the whole bowel segment in Bristol stool types 3 to 7 group was higher than Bristol stool types 1 and 2 group,while there was no difference in right colon.The bowel preparation score of left colon and the whole bowel segment in the last defecation consisting of solid composition was higher than the other group,while there was no difference in right and transverse colon.The bowel preparation score of three colon segments and the whole bowel segment in the time interval between bowel preparation and colonoscopy<6h group was higher than the time interval>6h group.ConclusionThe independent risk factors associated with suboptimal bowel preparation are not taking simethicone,consumption of PEG<75%,Bristol stool types 1 and 2,the last defecation consisting of solid composition and the time interval between bowel preparation and colonoscopy>6h.If we can identify above risk factors and make interventions,especially in the right colon,the bowel preparation quality will be enhanced,the miss rate of adenoma/polyp will be reduced.Meanwhile,patients will avoid suffering bowel preparation again in a short time,which will reserve medical resources.