Prevalence survey of bowel preparation quality in patients receiving colorectal polypectomy in day ward

doi:10.3877/cma.j.issn.2095-3224.2020.06.007

Abstract

Abstract:

Objective

To investigate the status of bowel preparation in patients receiving colorectal polypectomy in the day ward.

Methods

A total of 4 278 patients who had undergone bowel polypectomy in the day wards, inpatient wards, and outpatient clinic of Shanghai Changhai Hospital during July 2018 and April 2019 were included. The quality of bowel preparation was calculated. The relationship between the quality of bowel preparation and the patient's gender, cecal intubation, source, time period and work shift was analyzed.

Results

Among the 4 278 patients, 14.7% of the patients had unqualified bowel preparations, and that of men were significantly worse than that of women (χ²=11.091, P<0.05). The quality of bowel preparation of the outpatients was significantly better than that of the day wards and inpatient wards (χ²=16.610, P<0.05). The quality of bowel preparation in the morning and afternoon was significantly better than that in the evening (χ²=14.508, P<0.05). The proportion of patients in the day ward receiving colonoscopy in the evening and overtime is higher than that of outpatient and inpatient obviously.

Conclusions

Generally, the bowel preparation of patients receiving colorectal polypectomy in the day ward is not good. The main problem is the uncertainty of the patient's procedure time, which prolongs the interval between bowel preparation and procedure of most patients to exceed the recommended interval. Medical administrators should consider applying various methods to improve the quality of bowel preparation of ambulatory patients.

Key words: Colon, Polyps, Ambulatory medicine, Colorectal polypectomy, Bowel preparation

Junjun Gu, Ziye Zhao, Wenjun Han, Qin Wu, Miao Wang, Jia Chen, Ting Yang, Enda Yu. Prevalence survey of bowel preparation quality in patients receiving colorectal polypectomy in day ward[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2020, 09(06): 576-580.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhjzcjbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3224.2020.06.007

https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2020/V09/I06/576

Figures/Tables 3

References 22

[1]	国际日间手术学会. 日间手术手册[M]. 北京: 人民卫生出版社, 2015.
[2]	蒋丽莎，马洪升. 日间手术评价与监控指标初探[J]. 华西医学, 2019, 34(2): 202-205.
[3]	张继东，闻大翔，骆华杰, 等. 日间医疗的实践探索与思考[J]. 中华医院管理杂志, 2017, 33(5): 345-348.
[4]	袁华娣，张秀来，马戈, 等. 基于患者安全的日间手术管理体系构建[J]. 中华医院管理杂志, 2017, 33(5): 352-354.
[5]	中华医学会消化内镜学分会. 中国消化内镜诊疗相关肠道准备共识意见[J]. 中华消化内镜杂志, 2013, 30(10): 541-549.
[6]	Gu P, Lew D, Oh SJ, et al. Comparing the real-world effectiveness of competing colonoscopy preparations: Results of a prospective trial[J]. Am J Gastroenterol, 2019, 114(2): 305-314.
[7]	Spadaccini M, Frazzoni L, Vanella G, et al. Efficacy and tolerability of high- vs low-volume split-dose bowel cleansing regimens for colonoscopy: a systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol 2020, 18(7): 1454-1465, e1414.
[8]	Aronchick CA, Lipshutz WH, Wright SH, et al. Validation of an instrument to assess colon cleansing [abstract][J]. Am J Gastroenterol, 1999, 94: 2667.
[9]	赵子夜，李骏强，单永琪, 等. 结直肠癌平均风险人群结肠镜检查息肉发现率与腺瘤发现率及其年龄分布情况[J]. 中华消化内镜杂志, 2014, 31(2): 64-68.
[10]	Allen JI. The Value of Colonoscopy [J]. Gastroenterology, 2014, 146: 573-375.
[11]	Wang CL, Huang ZP, Chen K, et al. Adenoma miss rate determined by very shortly repeated colonoscopy: Retrospective analysis of data from a single tertiary medical center in China [J]. Medicine (Baltimore), 2018, 97(38): e12297.
[12]	Zhao S, Wang S, Pan P, et al. Magnitude, risk factors, and factors associated with adenoma miss rate of tandem colonoscopy: a systematic review and meta-analysis [J]. Gastroenterology, 2019, 156(6): 1661-1674, e11.
[13]	Rex DK, Schoenfeld PS, Cohen J, et al. Quality indicators for colonoscopy[J]. Gastrointest Endosc, 2015, 81(1): 31-53.
[14]	Chan WK, Saravanan A, Manikam J, et al. Appointment waiting times and education level influence the quality of bowel preparation in adult patients undergoing colonoscopy [J]. BMC Gastroenterol, 2011, 11: 86.
[15]	胡祥鹏，谢菁. 聚乙二醇电解质散肠道准备无效因素分析[J]. 中国内镜杂志, 2015, 21(8): 861-863.
[16]	Johnson DA, Barkun AN, Cohen LB, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer [J]. Gastroenterology, 2014, 147(4): 903-924.
[17]	刘俐，杨梅，张另. 内镜下治疗结肠息肉在日间病房与住院病房中的回顾性病例对照研究[J]. 第三军医大学学报, 2017, 39(18): 1832-1835.
[18]	Kim TK, Kim HW, Kim SJ, et al. Importance of the time interval between bowel preparation and colonoscopy in determining the quality of bowel preparation for full-dose polyethylene glycol preparation [J]. Gut Liver, 2014, 8(6): 625-631.
[19]	Seo EH, Kim TO, Park MJ, et al. Optimal preparation-to-colonoscopy interval in split-dose PEG bowel preparation determines satisfactory bowel preparation quality: an observational prospective study [J]. Gastrointest Endosc, 2012, 75(3): 583-590.
[20]	蔡贤黎，沈月红，李全林, 等. 消化内镜日间手术病房行结肠镜肠道准备的可行性研究[J]. 中华消化内镜杂志, 2019, 36(5): 334-338.
[21]	Marcondes FO, Gourevitch RA, Schoen RE, et al. Adenoma detection rate falls at the end of the day in a large multi-site sample [J]. Dig Dis Sci, 2018, 63(4): 856-859.
[22]	Long MD, Martin C, Sandler RS, et al. Reduced polyp detection as endoscopy shift progresses: experience with screening colonoscopy at a tertiary-care hospital [J]. J Clin Gastroenterol, 2011, 45(3): 253-258.

因素		例次数（n=4 278）	肠道准备质量		检验值	P值^*
因素		例次数（n=4 278）	差（n=627）	好（n=3 651）	检验值	P值^*
年龄^**			56.88±10.65	56.40±10.46	-1.064	0.287
性别					11.091	0.001^*
	男	3 022	478	2 544
	女	1 256	149	1 107
盲肠进镜						0.000^*
	完成	4 270	619	3 651
	未完成	8	8	0
来源					16.610	0.000^*
	门诊	2 177	272	1 905
	住院病房	1 239	211	1 028
	日间病房	862	144	718
时间档					14.508	0.001^*
	上午	2 147	289	1 858
	下午	1 732	255	1 477
	晚间	399	83	316
工作档					13.199	0.000^*
	上班	2 758	364	2 394
	加班	1 520	263	1 257

因素		例次数（n=4 278）	肠道准备质量		检验值	P值^*
因素		例次数（n=4 278）	差（n=627）	好（n=3 651）	检验值	P值^*
年龄^**			56.88±10.65	56.40±10.46	-1.064	0.287
性别					11.091	0.001^*
	男	3 022	478	2 544
	女	1 256	149	1 107
盲肠进镜						0.000^*
	完成	4 270	619	3 651
	未完成	8	8	0
来源					16.610	0.000^*
	门诊	2 177	272	1 905
	住院病房	1 239	211	1 028
	日间病房	862	144	718
时间档					14.508	0.001^*
	上午	2 147	289	1 858
	下午	1 732	255	1 477
	晚间	399	83	316
工作档					13.199	0.000^*
	上班	2 758	364	2 394
	加班	1 520	263	1 257

因素		门诊	肠道准备		检验值	P值^*	住院	肠道准备		检验值	P值	日间	肠道准备		检验值	P值
因素		门诊	差	好	检验值	P值^*	住院	差	好	检验值	P值	日间	差	好	检验值	P值
总数		2 177	272	1 905			1 239	211	1 028			862	144	718
年龄^**			57.18±10.88	56.37±10.77	-1.148	0.251		55.67±10.15	55.37±9.79	-0.405	0.686		58.10±10.83	57.94±10.40	0.167	0.867
性别					4.718	0.030^*				2.285	0.131				2.350	0.125
	男	1 467	199	1 268			961	172	789			594	107	487
	女	710	73	637			278	39	239			268	37	231
盲肠进镜						0.000^*					0.002^*					0.000^*
	完成	2 174	269	1 905			1 237	209	1 028			859	141	718
	未完成	3	3	0			2	2	0			3	3	0
时间档					0.151	0.927				6.100	0.047^*				10.525	0.005^*
	上午	1 263	155	1 108			719	111	608			165	23	142
	下午	800	102	698			491	91	400			441	62	379
	晚间	114	15	99			29	9	20			256	59	197
工作档					3.743	0.053				1.048	0.306				4.669	0.031^*
	上班	1 602	187	1 415			732	118	614			424	59	365
	加班	575	85	490			507	93	414			438	85	353

因素		门诊	肠道准备		检验值	P值^*	住院	肠道准备		检验值	P值	日间	肠道准备		检验值	P值
因素		门诊	差	好	检验值	P值^*	住院	差	好	检验值	P值	日间	差	好	检验值	P值
总数		2 177	272	1 905			1 239	211	1 028			862	144	718
年龄^**			57.18±10.88	56.37±10.77	-1.148	0.251		55.67±10.15	55.37±9.79	-0.405	0.686		58.10±10.83	57.94±10.40	0.167	0.867
性别					4.718	0.030^*				2.285	0.131				2.350	0.125
	男	1 467	199	1 268			961	172	789			594	107	487
	女	710	73	637			278	39	239			268	37	231
盲肠进镜						0.000^*					0.002^*					0.000^*
	完成	2 174	269	1 905			1 237	209	1 028			859	141	718
	未完成	3	3	0			2	2	0			3	3	0
时间档					0.151	0.927				6.100	0.047^*				10.525	0.005^*
	上午	1 263	155	1 108			719	111	608			165	23	142
	下午	800	102	698			491	91	400			441	62	379
	晚间	114	15	99			29	9	20			256	59	197
工作档					3.743	0.053				1.048	0.306				4.669	0.031^*
	上班	1 602	187	1 415			732	118	614			424	59	365
	加班	575	85	490			507	93	414			438	85	353

Please choose a citation manager

Content to export