Difficult colonoscopy score identifies the difficult patients undergoing unsedated colonoscopy

BMC Gastroenterology

Research Article

Hui Jia¹  Rui Huang¹  Xiaoyu Kang¹  Xuegang Guo¹  Hui Luo¹  Xiangping Wang¹  Zhiguo Liu¹  Yanglin Pan¹  Shaowei Yao¹  Linhui Zhang¹  Limei Wang² 

[1] Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China;Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xian, China;Shannxi Second People’s Hospital, Xian, China;

关键词: Sleep Quality;    Bowel Preparation;    Insertion Time;    Adenoma Detection Rate;    Abdominal Compression;   

DOI  :  10.1186/s12876-015-0273-7

 received in 2014-10-15, accepted in 2015-03-23,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMany factors have been found to affect the difficulty of colonoscope insertion, such as age, gender, body mass index (BMI), history of abdominal surgery and operator etc. However, a scoring system may be more useful to predict the difficulty during colonoscopy.MethodsThe individual and procedure-related data of 616 patients undergoing colonoscopy were prospectively collected from December 2013 through February 2014 in Xijing Hospital of Digestive Diseases. Cox regression analysis was used to identify high-risk factors associated with difficulty of colonoscopy. A predicting model with the difficult colonoscopy score (DCS) was developed.ResultsTotal cecum intubation rate was 98.9% (609/616). Advanced age, lower BMI, inexperienced operator and fair or poor sleep quality were identified as independent factors of prolonged insertion time (all p < 0.05), which were used to develop the DCS. Based on the score, patients could be divided into high-risk and low-risk groups with distinct incomplete rates within 10 min (42.0% vs. 16.5%, p < 0.001). Compared with those with DCS ≤ 1, patients with DCS > 1 had increased insertion time (10.6 ± 0.7 min vs. 6.9 ± 0.2 min, p < 0.001) and pain score (1.9 ± 1.5 vs. 1.4 ± 1.4, p = 0.002). More abdominal compression (36.9% vs. 16.8%, p < 0.001) and position change (51.4% vs. 22.6%, p < 0.001) were needed in this group of patients.ConclusionPatients with DCS > 1 had longer insertion time, higher pain score and needed more abdominal compression and position changes. DCS was useful for predicting the difficulty of colonoscope intubation.(ClinicalTrials.gov NCT02105025 05/05/2014).

【 授权许可】

Unknown   
© Jia et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.