Article Text

PTU-002 Analysis of factors predicting complete colonoscopy at a large teaching hospital
  1. A J Ball,
  2. J S Leeds,
  3. J M Hebden,
  4. M T Donnelly
  1. Department of Gastroenterolgy, Northern General Hospital, Sheffield, UK


Introduction Caecal intubation rate (CIR) is an important quality assurance measure in colonoscopy. There are many factors known to affect this including; sex of patient, BMI, age, timing of list and volume of colonoscopies performed by endoscopist. We analysed the factors that predict colonoscopy completion in a high throughput UK Centre.

Methods All patients that had colonoscopy over the course of a year were identified from the Sheffield Teaching Hospitals database (Infoflex). Potential determinants of CIR analysed include: patient factors (age, sex and indication for procedure); procedural factors (IV sedation used, endoscopist: gastroenterologist vs surgeon vs nurse). Individual factors were assessed using χ2 test and subsequently multivariate analysis to identify independent risk factors for non-completion.

Results 5227 colonoscopies were performed between September 2008 and August 2009 at Sheffield teaching hospitals. 50 of these were excluded from analysis due to incomplete information leaving a total of 5177 colonoscopies to analyse. The mean age of patients was 61.39 with an almost equal sex split (47.4% male). Seven nurse endoscopists performed 2380 procedures (mean 340/person), 28 gastroenterologists performed 1754 procedures (mean 63/person), 19 surgeons performed 858 procedures (mean 45/person). The overall CIR was 89.9%. Factors associated with non-completion on univariate analysis include; Female sex (352/2692 incomplete in females vs 168/2415 in males, OR 1.9 p=<0.001) age >64 (295/2573 incomplete in ≤64 vs 236/2737 in those >64, OR 1.3 p =<0.001). Procedural indications with a significantly different CIR included: abdominal pain (76/579 with vs 448/4598 without, OR 1.3 p=0.01) anaemia (125/1034 with vs 399/4143 without, OR 1.3 p=0.01) weight loss (39/198 with vs 485/4940 without, OR 1.7 p=0.009), non-surveillance (43/703 in surveillance patients vs 481/4474 in non-surveillance, OR 1.8 p=<0.001). Use of iv sedation reduced CIR (243/2082 with vs 281/3095 without, OR 1.3 p=0.002). Endoscopist factors associated with non-completion include non-nurse endoscopist (218/2380 incomplete for nurses vs 306/2797 in non-nurses, OR 1.2 p=0.04) Multivariate analysis identified several independent factors for non-completion (Abstract 002).

Abstract PTU-002

Independent risk factors for non-completion

Conclusion Our study has identified new independent factors that predict CIR. These include; patient factors (Indication of weight loss) and endoscopist factors (nurse endoscopist). We feel nurse endoscopist is likely to be a surrogate marker for volume of colonoscopies performed. Perhaps this indicates fewer endoscopists should be performing more procedures.

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