title: Factors related to bowel cleansing failure before colonoscopy: Results of the PACOME study.
abstract: BACKGROUND
  The factors associated with inadequate bowel cleansing leading to colonoscopy failure are not well known.
  
  
  OBJECTIVE
  We conducted a multicentre, prospective, observational case-control study in order to identify these factors.
  
  
  METHODS
  Investigators included one patient with colonoscopy failure due to inadequate bowel cleansing (failure group) and the following patient with complete colonoscopy (success group). Data related to demographics, medical history, and preparation were collected and compared. Factors associated with bowel cleansing failure were identified by multivariate logistical regression analysis.
  
  
  RESULTS
  A total of 101 gastroenterologists included 202 patients from 1 November 2009 to 15 January 2010. There was no difference between both groups with regards to baseline characteristics. In univariate analysis, factors significantly associated with bowel cleansing failure were vomiting during preparation (p = 0.0007), incomplete intake of the preparation (p = 0.002), and constipation (p = 0.02). Type and timing of preparation were not significantly different between groups. In multivariate analysis, incomplete intake of the preparation (OR 4.5, 95% CI 1.2-17.3), constipation (OR 4.2, 95% CI 1.2-14.9), and treatment with neuroleptics or antidepressants (OR 9.9 (95% CI 1.4-71.0) were independent predictors of colonoscopy failure.
  
  
  CONCLUSIONS
  Factors associated with bowel cleansing failure were incomplete intake of the preparation, constipation, and treatment with psychotropic drugs. Interventions to reduce poor colonoscopy preparations should be targeted at these at-risk patients.
authors.affiliation: Hôpital de la Timone, Assistance Publique des hôpitaux de Marseille, Marseille, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Hautefeuille
authors.affiliation: Clinique Saint Jean Languedoc, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Lapuelle
authors.affiliation: Hôpital Cochin, Assistance Publique des hôpitaux de Paris, Paris, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
authors.affiliation: Hôpital Edouard Herriot, Lyon, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Ponchon
authors.affiliation: Bordeaux, France.
authors.forename: B Richard
authors.initials: BR
authors.lastname: Molard
authors.affiliation: Clinique Saint Jean Languedoc, Toulouse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Coulom
authors.affiliation: Hôpital de la Timone, Assistance Publique des hôpitaux de Marseille, Marseille, France.
authors.forename: René
authors.initials: R
authors.lastname: Laugier
authors.affiliation: Laboratoires Mayoly Spindler, Chatou, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Henri
authors.affiliation: Hôpital Robert Debré, Reims, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
keywords: Bowel preparation; inadequate bowel cleansing; risk factors