Analysis of variation in pre-procedural fasting duration for common inpatient gastrointestinal procedures.

Autor:	Sakulsaengprapha V; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Daniel M; Washington University School of Medicine in St. Louis, Department of Gastroenterology, Barnes-Jewish Hospital, St. Louis, MO, USA., Cai J; Division of Health Sciences Informatics, Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Martinez DA; Division of Health Sciences Informatics, Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Mathews SC; Division of Gastroenterology and Hepatology, Johns Hopkins Medicine, Baltimore, MD, USA.; Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, Baltimore, MD, USA.
Jazyk:	angličtina
Zdroj:	Translational gastroenterology and hepatology [Transl Gastroenterol Hepatol] 2022 Oct 25; Vol. 7, pp. 39. Date of Electronic Publication: 2022 Oct 25 (Print Publication: 2022).
DOI:	10.21037/tgh-20-280
Abstrakt:	Background: Gastrointestinal procedures generally require pre-procedural fasting to optimize sedation safety. While the American Society of Anesthesiologists (ASA) recommends no intake of clear liquids and solid food 2-4 and 6-8 hours respectively prior to endoscopic procedures, the actual nil per os (NPO) duration for these procedures in practice is unknown. Our objective was to analyze NPO duration for patients undergoing these procedures and to determine its association with clinical and administrative variables. Methods: Inpatient data from 2016-2018 for the three procedures was extracted from electronic medical records and administrative data at a single-center tertiary academic medical center. Various statistical tests (Kruskal-Wallis, Wilcoxon, Pearson) were employed depending on the outcome type and data distribution. Results: One thousand three hundred and twenty-five esophagogastroduodenoscopies (EGDs), 753 colonoscopies, and 550 endoscopic retrograde cholangiopancreatographies (ERCPs) were included. The median NPO time for all procedures was 12.6 hours (IQR, 9.6-16.1 hours). The median NPO times were 12.6, 11.9, and 13.1 hours for EGD, colonoscopy, and ERCP respectively. NPO duration was greater for Hispanic than non-Hispanic patients (median 13.9 vs . 12.4, P=0.018). NPO duration was also associated with increased age (r=0.041, P=0.027) and inversely related to hospital occupancy (r=-0.08, P<0.0001). There were no statistically significant associations with provider type, hospital location or service, length of stay, and total number of comorbidities. Conclusions: NPO times for common inpatient gastroenterology (GI) procedures generally exceeded 12 hours, suggesting there is an opportunity to adopt changes to decrease NPO duration for low-risk patients while maintaining adherence to guidelines and best practice. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-20-280/coif). The authors have no conflicts of interest to declare. (2022 Translational Gastroenterology and Hepatology. All rights reserved.)
Databáze:	MEDLINE
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