Gut Liver.  2016 Jul;10(4):569-573. 10.5009/gnl15230.

Effect of Functional Status on the Quality of Bowel Preparation in Elderly Patients Undergoing Screening and Surveillance Colonoscopy

Affiliations
  • 1Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. akash.kumar@mssm.edu
  • 2Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 3Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 4Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • 5Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Abstract

BACKGROUND/AIMS
Optimal bowel preparation is essential for successful screening or for surveillance colonoscopy (SC). Inadequate bowel preparation is associated with older age, the male gender, and the presence of certain comorbidities. However, the association between patients' functional status and bowel preparation quality has not been studied. We prospectively examined the relationship between functional status, namely, the ability to perform activities of daily living (ADLs) and ambulate, and the quality of bowel preparation in elderly patients undergoing SC.
METHODS
Before undergoing SC, 88 elderly patients were surveyed regarding their functional status, specifically regarding their ability to perform ADLs and ambulate a quarter of a mile. Gastroenterologists then determined the quality of the bowel preparation, which was classified as either adequate or inadequate. Then, the frequency of inadequate bowel preparation in patients who did or did not experience difficulty performing ADLs and ambulating was calculated.
RESULTS
Difficulty ambulating (unadjusted odds ratio [OR], 4.83; p<0.001), difficulty performing ADLs (OR, 2.93; p=0.001), and history of diabetes (OR, 2.88; p=0.007) were significant univariate predictors of inadequate bowel preparation. After adjusting for the above variables, only difficulty ambulating (adjusted OR, 5.78; p=0.004) was an independent predictor of inadequate bowel preparation.
CONCLUSIONS
Difficulty with ambulation is a strong predictor of inadequate bowel preparation in elderly patients undergoing SC.

Keyword

Colonoscopy; Bowel preparation; Geriatric; Practice improvement

MeSH Terms

Activities of Daily Living
Aged
Aged, 80 and over
Cathartics/*adverse effects
*Colonoscopy
Female
Geriatric Assessment/*methods
Humans
Male
Odds Ratio
Preoperative Care/*adverse effects/methods
Prospective Studies
Risk Factors
Treatment Outcome
Walking
Cathartics
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