Low-Volume Bowel Preparation Is Associated With Reduced Time to Colonoscopy in Hospitalized Patients: A Propensity-Matched Analysis.

Autor:	Sun CLF; Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.; Healthcare Systems Engineering, Massachusetts General Hospital, Boston, Massachusetts, USA., Li DK; Section of Digestive Diseases, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA., Zenteno AC; Healthcare Systems Engineering, Massachusetts General Hospital, Boston, Massachusetts, USA.; Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts, USA., Bravard MA; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Carolan P; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA., Daily B; Healthcare Systems Engineering, Massachusetts General Hospital, Boston, Massachusetts, USA.; Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts, USA., Elamin S; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Ha J; Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA., Moore A; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA., Safavi K; Healthcare Systems Engineering, Massachusetts General Hospital, Boston, Massachusetts, USA.; Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Harvard, Boston, Massachusetts, USA., Yun BJ; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA ., Dunn P; Healthcare Systems Engineering, Massachusetts General Hospital, Boston, Massachusetts, USA.; Perioperative Services, Massachusetts General Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Harvard, Boston, Massachusetts, USA., Levi R; Sloan School of Management, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA., Richter JM; Harvard Medical School, Harvard, Boston, Massachusetts, USA.; Gastrointestinal Division, Massachusetts General Hospital, Boston, Massachusetts, USA.
Jazyk:	angličtina
Zdroj:	Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2022 Jul 01; Vol. 13 (7), pp. e00482. Date of Electronic Publication: 2022 Mar 28.
DOI:	10.14309/ctg.0000000000000482
Abstrakt:	Introduction: Delays in inpatient colonoscopy are commonly caused by inadequate bowel preparation and result in increased hospital length of stay (LOS) and healthcare costs. Low-volume bowel preparation (LV-BP; sodium sulfate, potassium sulfate, and magnesium sulfate ) has been shown to improve outpatient bowel preparation quality compared with standard high-volume bowel preparations (HV-BP; polyethylene glycol ). However, its efficacy in hospitalized patients has not been well-studied. We assessed the impact of LV-BP on time to colonoscopy, hospital LOS, and bowel preparation quality among inpatients. Methods: We performed a propensity score-matched analysis of adult inpatients undergoing colonoscopy who received either LV-BP or HV-BP before colonoscopy at a quaternary academic medical center. Multivariate regression models with feature selection were developed to assess the association between LV-BP and study outcomes. Results: Among 1,807 inpatients included in this study, 293 and 1,514 patients received LV-BP and HV-BP, respectively. Among the propensity score-matched population, LV-BP was associated with a shorter time to colonoscopy (β: -0.43 [95% confidence interval: -0.56 to -0.30]) while having similar odds of adequate preparation (odds ratio: 1.02 [95% confidence interval: 0.71-1.46]; P = 0.92). LV-BP was also significantly associated with decreased hospital LOS among older patients (age ≥ 75 years), patients with chronic kidney disease, and patients who were hospitalized with gastrointestinal bleeding. Discussion: LV-BP is associated with decreased time to colonoscopy in hospitalized patients. Older inpatients, inpatients with chronic kidney disease, and inpatients with gastrointestinal bleeding may particularly benefit from LV-BP. Prospective studies are needed to further establish the role of LV-BP for inpatient colonoscopies. (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
Databáze:	MEDLINE
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