Barium enema in frail elderly patients.
BACKGROUND
Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients.


OBJECTIVE
The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients.


METHODS
Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed.


RESULTS
One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001).


CONCLUSIONS
The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly.
Segal
R
R
The Geriatric Medical Center, 'Shmuel Harofe', affiliated to the Sackler School of Medicine, Tel-Aviv University, Beer Yacov, Israel. shmuelh@netvision.net.il
Khahil
A
A
Leibovitz
A
A
Gil
I
I
Annuar
M
M
Habot
B
B
D000368:Aged; D001466:Barium Sulfate / Q000494:pharmacology*; D003108:Colonic Diseases / Q000000981:diagnostic imaging*; D004733:Enema; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies
D001466:Barium Sulfate