{
  "abstract": "Introduction A Retrospective Regression Model-Based Analysis of Factors Associated with Suboptimal Bowel Preparation During Colonoscopy.Background Adequate bowel preparation is essential for high-quality colonoscopy as poor-quality colonoscopy creates delay in diagnosis. Multiple patient- and procedure-related factors have been proposed to influence bowel preparation quality, but evidence remains inconsistent and very little study has been done in this topic to influence the clinical practice. This study aimed to evaluate predictors of bowel preparation quality using the Boston Bowel Preparation Scale (BBPS).Methods A retrospective analysis of colonoscopies was performed at Royal Derby Hospital, UK .Bowel preparation quality was assessed using the BBPS and only data with BPPS score <6 was analysed. Descriptive statistics summarised demographics, prep types, and Boston scores. Wilcoxon rank-sum tests were used for two-group comparisons of continuous Boston scores (e.g., AM vs PM lists, opiate use, prior surgery). Kruskal–Wallis tests were used for multi-group comparisons (e.g., different bowel prep regimens, diabetes categories). Multivariable linear regression assessed independent predictors of overall Boston score. Multivariable logistic regression assessed predictors of extreme poor bowel prep, defined as total Boston ≤2. Chi-square tests were used to assess associations between extreme poor prep and categorical variables such as age groups, gender, opiate use, prior surgery, and diabetes.Results A total of 1,482 colonoscopies were included; 19 cases were excluded due to missing data. Mean patient age was 61.9 years, and 48.3% were female. The median total BBPS was 3 (IQR 3–4).There was no significant association between total BBPS and procedure timing (AM vs PM, p=0.298), opiate use (p=0.116), prior abdominal surgery (p=0.910), diabetes category (p=0.115), or bowel preparation regimen (p=0.384). Multivariable linear regression demonstrated no independent predictors of total BBPS (adjusted R2 = 0.003). Extreme poor bowel preparation occurred in 23.1% of cases (342/1,482). Multivariable logistic regression showed no significant association between extreme poor preparation and age (p=0.760), gender (p=0.527), procedure timing (p=0.312), opiate use (p=0.635), prior surgery (p=0.626), diabetes (p=0.565), or bowel preparation regimen (all p>0.50).Conclusion In this large cohort, no patient-, procedure-, or preparation-related factors were associated with bowel preparation quality. No independent predictors of extreme poor bowel preparation were identified, highlighting the ongoing challenge of predicting inadequate bowel preparation in routine clinical practice. Hence, more focus should be given on dietary advice (including low fibre diet) or educational video can help to improve the outcome of Colonoscopy quality in practice which will improve clinical governance.",
  "authors": [
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Aashish Khanal"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Pukar Neupane"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Nnamdi Emekekwue"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Nurul Asyiqin Binti Mohamed Halim"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Douglas Sanni"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Ebubechukwu Ogbuagu"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Rakshita Agrawal"
    },
    {
      "affiliations": [
        "Royal Derby Hospital, Uttoxeter New Road, United Kingdom"
      ],
      "name": "Modupe Ojelabi"
    }
  ],
  "title": "P360 A retrospective regression model-based analysis of factors associated with suboptimal bowel preparation during colonoscopy",
  "uid": "efff44e9-68d7-5483-ae57-5c6f7b7a2c73"
}