Impact of sedation on the Performance Indicator of Colonic Intubation.
Endoscopy
; 53(6): 619-626, 2021 06.
Article
em En
| MEDLINE
| ID: mdl-32882721
ABSTRACT
BACKGROUND:
The Performance Indicator of Colonic Intubation (PICI) is a new measure of high-quality colonic intubation. Adequate PICI was defined as cecal intubation without significant discomfort and use of minimal sedation. This study assessed achievement of PICI within the Dutch colorectal cancer (CRC) screening program, and determined the association between PICI and adenoma detection rate (ADR). PICI achievement when using the Dutch median midazolam dose was also assessed.METHODS:
This retrospective study was conducted within the Dutch fecal immunochemical test-based CRC screening program. Colonoscopy and pathology data were prospectively collected in a national database. Data between January 2016 through January 2018 were analyzed. Adequate PICI was defined as successful cecal intubation, Gloucester Comfort Scale (GCS) of 1â-â3, and use of ≤â2.5âmg midazolam.RESULTS:
107â328 colonoscopies were performed during the study period. Adequate PICI was achieved in 49â500 colonoscopies (46.1â%). In colonoscopies with inadequate PICI, inadequacy was due to higher sedation doses in 87.8â%. Adequate PICI was associated with higher ADR (odds ratio 1.16, 95â% confidence interval 1.12â-â1.20). When using a cutoff of 5âmg midazolam, median dose in this Dutch population, adequate PICI was achieved in 95â410 colonoscopies (88.9ââ%).CONCLUSION:
PICI appeared to be heavily dependent on sedation practice. Because of wide variation in sedation practice between individual endoscopists and countries, the benefit of PICI as a quality indicator is limited.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Adenoma
/
Pólipos do Colo
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2021
Tipo de documento:
Article