Superiority of a preparation‐related model for predicting inadequate bowel preparation in patients undergoing colonoscopy: A multicenter prospective study. Issue 12 (27th October 2022)

• Record Type: Journal Article
• Authors: Chen, Long; Ren, Gui; Luo, Hui; Zhang, Linhui; Wang, Limei; Zhao, Jianghai; Zhang, Rongchun; Zhang, Xiaoying; Kang, Xiaoyu; Pan, Yanglin
• Is Part Of: Journal of gastroenterology and hepatology. Volume 37:Issue 12(2022)
• Page Start: 2297
• Page End: 2305
• Publication Date: 2022-10-27
• Subjects: bowel preparation -- colonoscopy -- prediction model -- risk factor; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.16010
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: Three models based on patient‐related factors have been developed to predict inadequate bowel preparation (BP). However, the performance of the models seems suboptimal. This study aimed to develop a novel preparation‐related model and compare it with the available patient‐related models. Methods: Patients receiving standard BP were prospectively enrolled from five endoscopic centers. Patient‐related and preparation‐related factors for inadequate BP (defined by segmental Boston Bowel Preparation Scale score < 2) were identified by logistic regression. A preparation‐related model was derived and internally validated in 906 patients. The comparisons of models were assessed by discrimination and calibration. The preparation‐related model was also externally validated. Results: Several patient‐related factors (male and American Society of Anesthesiologists Physical Status Classification System score ≥ 3) and preparation‐related factors (drinking‐to‐stool interval ≥ 3 h, preparation‐to‐colonoscopy interval ≥ 6 h, and poor rectal effluent) were found to be independently associated with inadequate BP (all P < 0.05). C ‐statistics was 0.81 for the preparation‐related model in the training cohort ( n = 604), significantly higher than three available patient‐based models (0.58–0.61). Similar results were observed in the validation cohort ( n = 302). Calibration curves showed close agreement in the preparation‐related model ( R 2 = 0.315 in the training cohort and 0.279 in the validation cohort). The preparation‐related model was externally validated in another 606 patients with C ‐index of 0.80. Conclusions: A new preparation‐related model (consisting of drinking‐to‐stool interval ≥ 3 h, preparation‐to‐colonoscopy interval ≥ 6 h, and poor last rectal effluent) was developed and performed better than three available patient‐related models. This easy‐to‐use model may be a useful decision‐support tool on individualized plans in patients undergoing BP.