Influencing factors for inadequate bowel preparation of colonoscopy of different colonic segments / 中华消化内镜杂志

ABSTRACT

Objective:To investigate the influencing factors for inadequate bowel preparation of colonoscopy.Methods:A total of 677 patients who underwent colonoscopy at Peking Union Medical College Hospital from December 2021 to January 2023 were recruited, and all patients underwent standardized bowel preparation by using 3 L polyglycol electrolyte powder with fractional dose. The quality of bowel preparation was assessed by Boston bowel preparation scale, and the influencing factors for inadequate bowel preparation were analyzed by logistic regression analysis.Results:The rate of inadequate bowel preparation was 31.5% (213/677). Among the patients with inadequate bowel preparation, 85.4% (182/213) inadequate bowel preparation was only in proximal colon, 14.1% (30/213) was in both proximal and distal colon, and 0.5% (1/213) was only in distal colon. Inadequate bowel preparation in distal colon and total colon were combined into inadequate bowel preparation in distal colon. The results of logistic regression analysis showed that inadequate bowel preparation in proximal colon was more likely to occur in men ( P=0.001, OR=2.253, 95% CI 1.399-3.629), outpatients ( P<0.001, OR=4.175, 95% CI 2.410-7.231), those with no family history of colorectal cancer ( P=0.001, OR=2.117, 95% CI 1.365-3.284), and diagnostic colonoscopy ( P=0.003, OR=1.978, 95% CI 1.261-3.102). And spinal disease ( P=0.044, OR=7.430, 95% CI 1.051-52.511), outpatients ( P<0.001, OR=135.577, 95% CI 29.135-630.883),non-compliance of dietary requirements ( P=0.006, OR=4.772, 95% CI 1.576-14.453), adverse reaction during bowel preparation ( P=0.015, OR=4.341, 95% CI 1.329-14.179), no family history of colorectal cancer ( P=0.003, OR=7.110, 95% CI 1.912-26.438), and poor last stool character ( P=0.001, OR=25.922, 95% CI 3.779-177.832) were risk factors for inadequate bowel preparation in distal colon. Conclusions:The inadequate bowel preparation of colonoscopy mainly occurs in proximal colon, and the risk factors for the inadequate bowel preparation vary in different colonic segments. Therefore, the specific interventions should be performed according to the character of different colon segments to improve the quality of bowel preparation.