Mo1557 Physician's Fatigue Influences on Adenoma Detection Rate and Polyp Detection Rate

Physician's fatigue, which usually increases as the day progresses, may impact adenoma detection rate (ADR) and polyp detection rate (PDR) like known affecting factors. The aim of this study is to determine the influence of timing of colonoscopy on the ADR and PDR. From December 2007 to November 2008, 1,293 consecutive, asymptomatic, average-risk people between 50 and 75 years of age who underwent screening colonoscopy from four tertiary medical centers were included. 412 colonoscopies (32%) were done in the morning and 881 (68%) were done in the afternoon. There was significantly higher ADR and PDR in the morning colonoscopy compared to afternoon colonoscopy (42.3 vs 34.7%, p=0.008 and 52.5 vs 46.3%, p=0.038). The trend of both ADR and PDR was decline in each subsequent hour passage of the day (44.6% vs 26.1% (p=0.089) and 59.4% vs 44.9% (p=0.118)) and in each subsequent hour passage of the morning and afternoon (42.2% vs. 32.6% (p=0.147) and 43.0% vs 55.5% (p=0.039)). In the multivariable analysis, afternoon colonoscopies and colonoscopies performed after more than 4 hours in each morning and afternoon were significantly associated with a decreased ADR (OR 0.739 (0.576-0.949) p=0.018 and OR 0.651 (0.443-0.975) p=0.029) and the decreased PDR(OR 0.792 (0.620-1.011) p=0.061 and OR 0.723 (0.488-1.073) p=0.107). ADR and PDR were significantly higher in the morning group than in the afternoon group. Colonoscopies performed after more than 4 hours in each morning and afternoon were associated with a decreased ADR and PDR.Tabled 1Demographic and endoscopic features of patientsFactorsMorning (n=412)Afternoon (n=881)p-valueAge (mean, range)58 (53-65)57 (52-63)0.54Male (%)233 (55.1)474 (54.5)0.839ADR (%)42.334.70.008PDR (%)52.546.30.038 Open table in a new tab