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Digestive Diseases and Sciences

, Volume 60, Issue 11, pp 3482–3490 | Cite as

Predictors of Inadequate Inpatient Colonoscopy Preparation and Its Association with Hospital Length of Stay and Costs

  • Rena YadlapatiEmail author
  • Elyse R. Johnston
  • Dyanna L. Gregory
  • Jody D. Ciolino
  • Andrew Cooper
  • Rajesh N. Keswani
Original Article

Abstract

Background/Aims

Adequate bowel preparation is essential to safe and effective inpatient colonoscopy. Predictors of poor inpatient colonoscopy preparation and the economic impacts of inadequate inpatient preparations are not defined. The aims of this study were to (1) determine risk factors for inadequate inpatient bowel preparations, and (2) examine the association between inadequate inpatient bowel preparation and hospital length of stay (LOS) and costs.

Methods

We performed a retrospective cohort study of adult patients undergoing inpatient colonoscopy preparation over 12 months (1/1/2013–12/31/2013).

Results

Of 524 identified patients, 22.3 % had an inadequate preparation. A multiple logistic regression model identified the following potential predictors of inadequate bowel preparation: lower income (OR 1.11; 95 % CI 1.04, 1.22), opiate or tricyclic antidepressant (TCA) use (OR 1.55; 0.98, 2.46), and afternoon colonoscopy (OR 1.66; 1.07, 2.59); as well as American Society of Anesthesiologists (ASA) class ≥3 (OR 1.15; 1.05, 1.25) and symptoms of nausea/vomiting (OR 1.14; 1.04, 1.25) when a fair preparation was considered inadequate. Inadequate bowel preparation was associated with significantly increased hospital LOS (model relative mean estimate 1.25; 95 % CI 1.03, 1.51) and hospital costs (estimate 1.31; 1.03, 1.67) when compared to adequate preparations.

Conclusions

The rate of inadequate inpatient bowel preparations is high and associated with a significant increase in hospital LOS and costs. We identified five potential predictors of inadequate inpatient preparation: lower socioeconomic class, opiate/TCA use, afternoon colonoscopies, ASA class ≥3, and pre-preparation nausea/vomiting; these data should guide future initiatives to improve the quality of inpatient bowel preparations.

Keywords

Bowel preparation Quality Inpatient colonoscopy 

Abbreviations

LOS

Length of stay

OR

Odds ratio

CI

Confidence interval

ASA

American Society of Anesthesiologists

TCA

Tricyclic antidepressant

GI

Gastrointestinal

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Rena Yadlapati
    • 1
    Email author
  • Elyse R. Johnston
    • 1
  • Dyanna L. Gregory
    • 1
  • Jody D. Ciolino
    • 1
  • Andrew Cooper
    • 1
  • Rajesh N. Keswani
    • 1
  1. 1.Division of Gastroenterology and Hepatology, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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