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Serum Albumin Concentrations Predict hypovolaemia Caused by Polyethylene Glycol Plus Ascorbic Acid Prior to Colonoscopy in Elderly Patients

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Abstract

Background

Previous studies have confirmed the safety of polyethylene glycol plus ascorbic acid for healthy middle-aged adults but not for the elderly. The osmotic pressure of polyethylene glycol plus ascorbic acid is approximately twice that of plasma osmolality and may cause dehydration.

Objective

In this study, we determined whether dehydration was induced in elderly patients by polyethylene glycol plus ascorbic acid, and we analysed the data obtained in order to identify predictors of dehydration.

Methods

This was a prospective, uncontrolled, before-and-after intervention study. All patients older than 65 years who underwent colonoscopies at the Moji Medical Center were administered polyethylene glycol plus ascorbic acid prior to colonoscopy. Clinical variables before and after bowel preparation were measured and analysed statistically. A multiple linear regression analysis was performed to identify predictors of dehydration due to this procedure.

Results

Eighty-three patients were assessed for eligibility, and 74 clinical variables were ultimately analysed. A significant increase in the red blood cell count (4.10 versus 4.25 × 106/mm3), haemoglobin level (12.4 versus 13.0 g/dL) and haematocrit (38.1 % versus 39.4 %) suggested the presence of hypovolaemia after the procedure (P < 0.001). The serum concentration of albumin before bowel preparation was identified as the only significant predictor of hypovolaemia (β = 0.47, P = 0.0001, adjusted R 2 = 0.22).

Conclusion

The serum concentration of albumin before bowel preparation predicted hypovolaemia caused by polyethylene glycol plus ascorbic acid in elderly patients. Therefore, care is needed in order to prevent hypovolaemia, especially in elderly patients with hypoalbuminaemia.

Trial Registration

No. 000015724 (University Hospital Medical Information Network Center).

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Acknowledgments

The authors thank Takamitsu Mizobe, MD, PhD, for his comments and suggestions, and the staff at the Endoscopic and Internal Medicine Department of the Moji Medical Center for their moral support and encouragement.

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Authors and Affiliations

  1. Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan

    Noriyoshi Ogino, Junji Oshima, Michihiko Shibata, Tatsuyuki Watanabe, Keiichiro Kume & Masaru Harada

  2. Department of Internal Medicine, Moji Medical Center, Kitakyushu, Japan

    Noriyoshi Ogino, Gentaro Aridome & Junji Oshima

  3. Department of Gastroenterology, Wakamatsu Hospital of University of Occupational and Environmental Health, Japan, Kitakyushu, Japan

    Gentaro Aridome

  4. Department of Endoscopy, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan

    Ichiro Yoshikawa

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  1. Noriyoshi Ogino
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Correspondence to Noriyoshi Ogino.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study.

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Conflicts of interest

Noriyoshi Ogino, Gentaro Aridome, Junji Oshima, Michihiko Shibata, Tatsuyuki Watanabe, Keiichiro Kume, Ichiro Yoshikawa and Masaru Harada declare that they have no conflicts of interest relevant to the content of this article.

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Ogino, N., Aridome, G., Oshima, J. et al. Serum Albumin Concentrations Predict hypovolaemia Caused by Polyethylene Glycol Plus Ascorbic Acid Prior to Colonoscopy in Elderly Patients. Drugs Aging 33, 355–363 (2016). https://doi.org/10.1007/s40266-016-0355-4

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  • DOI: https://doi.org/10.1007/s40266-016-0355-4

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