Tu1503 Quality of Bowel Cleansing in Hospitalized Patients Is Not Worse Than That of Outpatients Undergoing Colonoscopy: Results of a Multicenter Prospective Regional Study

Tu1503 Quality of Bowel Cleansing in Hospitalized Patients Is Not Worse Than That of Outpatients Undergoing Colonoscopy: Results of a Multicenter Prospective Regional Study Gianluca Rotondano*, Antonio Rispo, Maria E. Bottiglieri, Dario Bruzzese, Leonardo De Luca, Roberto Lamanda, Luigi Orsini, Giuseppe Galloro Gastroenterology, Hospital Maresca, Torre del Greco, Italy; Gastroenterology, University Federico II, Naples, Italy; Digestive Endoscopy, University Federico II, Naples, Italy; Gastroenterology, Pellegrini Hospital, Naples, Italy; Gastroenterology, Marcianise Hospital, Marcianise, Italy; Gastroenterology, Cardarelli Hospital, Naples, Italy; Statistics, University Federico II, Naples, Italy; Gastroenterology, La Schiana Hospital, Pozzuoli, Italy Background: safe and effective colonoscopy requires adequate bowel cleansing. The degree of bowel cleansing in hospitalized patients undergoing colonoscopy is often regarded as unsatisfactory compared to that of outpatients. To date, no focused study investigated the inpatient or outpatient setting as cause of inadequate cleansing. Aims: a) to assess the degree of bowel cleansing in inpatients vs. outpatients and b) identify possible predictors of poor bowel preparation in the two populations. Methods: prospective multicenter cross-sectional study including consecutive patients undergoing colonoscopy in 25 endoscopy units of Campania region in Southern Italy. Degree of bowel cleansing was rated on a segmental scoring scale of 1 to 4 by using a simplified Boston Bowel Preparation Scale. Univariate and multivariate analysis with odds ratio estimation were performed. Results: data from 3,276 colonoscopies were analyzed (2178 outpatients and 1098 inpatients). Inadequate colon cleansing (poor/fair) was recorded in 35.1% of cases at the level of proximal colon and 22.9% at left colon (p!0.01). An incomplete colonoscopy due to inadequate cleansing was recorded in 369 pts (11.2%), and in almost 50% of them it was due to poor cleansing of the proximal colon (p!0.001). There was no significant difference in bowel cleansing rates between inpatients and outpatients (23.5% and 22.6% fair/poor preparation vs. 76.5% and 77.4% good/excellent preparation, respectively. pZ0.58 and pZ0.18). The presence of comorbidity and co-prescriptions was significantly higher in inpatients than in outpatients (75.5% vs. 56.7% and 75.8% vs. 61.8%; p! 0.001). Regardless of the setting, independent predictors of poor bowel preparation were: male gender, presence of comorbidity (in particular diabetes), BMI O25, chronic constipation, absence of any explanation by medical or nursing staff, high-volume preparation, non-split dosage schedule and incomplete intake of the purge (Table). Conclusions: although the hospitalized population is at increased risk of inadequate bowel cleansing, there is no difference in the rate of inadequate preparation between inand outpatients This result could be the effect of the better explanation of the importance/modality of purge intake AB564 GASTROINTESTINAL ENDOSCOPY Volume 79, No. 5S : 2014 made by physicians and/or nurses that can in some way compensate the presence of several risk factors. Obesity, comorbidity, chronic constipation, hi-volume preparation, non-split dosage schedule and incomplete intake of the purge turned out to be independent predictors of poor bowel preparation. The project was named after and carried out in loving memory of our colleague and friend Roberto Piscopo, MD. independent predictors of inadequate (fair/poor) bowel cleansing at logistic regression analysis Right colon Left colon Adjusted OR [95% CI] P value Adjusted OR [95% CI]