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World J Gastrointest Endosc. May 16, 2014; 6(5): 186-192
Published online May 16, 2014. doi: 10.4253/wjge.v6.i5.186
Published online May 16, 2014. doi: 10.4253/wjge.v6.i5.186
Table 1 Criteria used to classify bowel preparation quality
Bowel preparation quality | Criteria |
Excellent | Mucosal detail clearly visible without washing (suctioning of liquid allowed |
Good | Minimal turbid fluid in colonic segments and entire mucosa well seen after cleaning |
Fair | There is minor residual material in the colonic segments. Necessary to suction liquid to adequately view the colonic segments |
Poor | Necessary to wash and suction to obtain a reasonable view. Portion of mucosa in colonic segments seen after cleaning but up to 15% of the mucosa not seen because of retained material |
Unsatisfactory | Solid stool not cleared with washing and suctioning. More than 15% of the mucosa not seen |
Table 2 Patient characteristics based on bowel preparation quality n (%)
Characteristics | Quality of bowel preparation | ||||
Excellent (n = 108) | Good (n = 4051) | Fair (n = 2889) | Poor (n = 1045) | Unsatisfactory (n = 238) | |
Mean age ± SD, yr | 58 ± 7.6 | 59 ± 7.6 | 59 ± 7.9 | 60 ± 7.7 | 59 ± 8.3 |
Women | 65 (60) | 2481 (61) | 1596 (55) | 537 (51) | 117 (49) |
Race | |||||
Asian | 1 (1) | 32 (1) | 16 (1) | 4 (0) | 0 (0) |
White | 1 (1) | 47 (1) | 34 (1) | 15 (1) | 5 (2) |
Black | 25 (23) | 875 (22) | 697 (24) | 280 (27) | 82 (35) |
Hispanic | 81 (75) | 3097 (77) | 2142 (74) | 746 (71) | 151 (63) |
Morning procedure | 45 (42) | 1877 (46) | 1212 (42) | 428 (41) | 78 (33) |
Table 3 Withdrawal time and polyp detection based on bowel preparation quality n (%)
Quality of bowel preparation | P-value | |||||
Excellent (n = 108) | Good (n = 4051) | Fair (n = 2889) | Poor (n = 1045) | Unsatisfactory (n = 238) | ||
Mean duration of colonoscope withdrawal ± SD, min | 10 ± 5.5 | 12 ± 5.3 | 13 ± 5.9 | 12 ± 5.2 | 11 ± 9.4 | < 0.001 |
No. of colonic segments with polyps | < 0.001 | |||||
0 | 85 (77) | 2707 (67) | 1799 (62) | 703 (67) | 181 (76) | |
1 | 17 (16) | 769 (19) | 581 (20) | 223 (21) | 38 (16) | |
2 | 3 (3) | 375 (9) | 305 (11) | 74 (7) | 13 (6) | |
3 | 1 (1) | 136 (3) | 145 (5) | 31 (3) | 6 (3) | |
4 | 2 (2) | 43 (1) | 38 (1) | 11 (1) | 0 (0) | |
5 | 0 (0) | 16 (0) | 18 (1) | 3 (0) | 0 (0) | |
6 | 0 (0) | 2 (0) | 3 (0) | 0 (0) | 0 (0) | |
7 | 0 (0) | 2 (0) | 0 (0) | 0 (0) | 0 (0) | |
8 | 0 (0) | 1 (0) | 0 (0) | 0 (0) | 0 (0) | |
Total No. of colonic polyps | < 0.001 | |||||
0 | 85 (77) | 2707 (67) | 1799 (62) | 703 (67) | 181 (76) | |
1 | 13 (12) | 581 (14) | 446 (15) | 42 (4) | 30 (13) | |
2 | 2 (2) | 231 (6) | 164 (6) | 60 (6) | 8 (3) | |
3 | 4 (4) | 256 (6) | 195 (7) | 37 (4) | 10 (4) | |
4 | 2 (2) | 152 (4) | 155 (5) | 22 (2) | 5 (2) | |
5 | 1 (1) | 73 (2) | 90 (3) | 6 (1) | 4 (2) | |
> 5 | 1 (1) | 51 (1) | 30 (1) | 2 (0) | 0 (0) |
Table 4 Predictors of higher number of colonic segments with polyps and total number of colonic polyps during screening colonoscopy
No. colonic segment with polyps | Total No. colonic polyps | |||
OR (95%CI) | P-value | OR (95%CI) | P-value | |
Older age | 1.01 (1.00-1.03) | 0.011 | 1.01 (1.00-1.02) | 0.026 |
Gender of male1 | 1.31 (1.11-1.55) | 0.002 | 1.18 (1.00-1.39) | 0.047 |
Race | ||||
Asian2 | 0.89 (0.34-2.25) | NS | 1.06 (0.41-2.73) | NS |
White2 | 0.69 (0.33-1.45) | NS | 0.70 (0.33-1.45) | NS |
Black2 | 1.17 (0.97-1.41) | NS | 1.22 (1.01-1.47) | 0.041 |
Later time of colonoscopy | 1.00 (1.00-1.00) | NS | 1.00 (1.00-1.00) | 0.043 |
Better bowel preparation quality | 1.10 (1.00-1.21) | 0.04 | 1.11 (1.01-1.22) | 0.030 |
Longer duration of colonoscope withdrawal | 1.14 (1.12-1.16) | < 0.0001 | 1.14 (1.12-1.16) | < 0.0001 |
Adenoma detection rate of endoscopist | 1.03 (1.02-1.04) | < 0.0001 | 1.03 (1.02-1.04) | < 0.0001 |
Duration of colonoscopy practice of endoscopist | 0.98 (0.97-0.98) | < 0.0001 | 0.98(0.97-0.99) | < 0.0001 |
Involvement of trainee during colonoscopy | 0.93 (0.72-1.19) | NS | 0.93(0.73-1.19) | NS |
Table 5 Association between longer withdrawal time and higher polyp detection in various bowel preparation qualities
No. of colonic segments with polyps | Total No. colonic polyps | |||
OR (95%CI)1 | P-value | OR (95%CI)1 | P-value | |
Excellent | 1.07 (0.99-1.26) | NS | 1.11 (0.99-1.24) | NS |
Good | 1.16 (1.13-1.19) | < 0.0001 | 1.15 (1.13-1.18) | < 0.0001 |
Fair | 1.13 (1.10-1.17) | < 0.0001 | 1.13 (1.10-1.16) | < 0.0001 |
Poor | 1.18 (1.11-1.26) | < 0.0001 | 1.20 (1.13-1.29) | < 0.0001 |
Unsatisfactory/very poor | 1.02 (0.99-1.12) | NS | 1.05 (0.99-1.10) | NS |
- Citation: Widjaja D, Bhandari M, Loveday-Laghi V, Glandt M, Balar B. Withdrawal time in excellent or very poor bowel preparation qualities. World J Gastrointest Endosc 2014; 6(5): 186-192
- URL: https://www.wjgnet.com/1948-5190/full/v6/i5/186.htm
- DOI: https://dx.doi.org/10.4253/wjge.v6.i5.186