J Gastroenterol Hepatol. 2022 Sep 30. doi: 10.1111/jgh.16010. Online ahead of print.
ABSTRACT
OBJECTIVES: Three models based on patient-related factors have been developed to predict inadequate bowel preparation (BP). However, the performance of the models seems suboptimal. This study aimed to develop a novel preparation-related model and compare it with the available patient-related models.
METHODS: Patients receiving standard BP were prospectively enrolled from 5 endoscopic centers. Patient-related and preparation-related factors for inadequate BP (defined by segmental Boston Bowel Preparation Scale score <2) were identified by logistic regression. A preparation-related model was derived and internally validated in 906 patients. The comparisons of models were assessed by discrimination and calibration. The preparation-related model was also externally validated.
RESULTS: Several patient-related factors (male and American Society of Anesthesiologists Physical Status Classification System score ≥3) and preparation-related factors (drinking-to-stool interval ≥3h, preparation-to-colonoscopy interval ≥6h and poor rectal effluent) were found to be independent associated with inadequate BP (all p<0.05). C-statistics was 0.81 for the preparation-related model in the training cohort (n=604), significantly higher than three available patient-based models (0.58-0.61). Similar results were observed in the validation cohort (n=302). Calibration curves showed close agreement in the preparation-related model (R2 =0.315 in the training cohort and 0.279 in the validation cohort). The preparation-related model was externally validated in another 606 patients with C-index of 0.80.
CONCLUSIONS: A new preparation-related model (consisting of drinking-to-stool interval ≥3h, preparation-to-colonoscopy interval ≥6h and poor last rectal effluent) was developed and performed better than three available patient-related models. This easy-to-use model may be a useful decision-support tool on individualized plans in patients undergoing BP.
PMID:36181263 | DOI:10.1111/jgh.16010
