title: Serum Albumin Concentrations Predict hypovolaemia Caused by Polyethylene Glycol Plus Ascorbic Acid Prior to Colonoscopy in Elderly Patients.
abstract: BACKGROUND
  Previous studies have confirmed the safety of polyethylene glycol plus ascorbic acid for healthy middle-aged adults but not for the elderly. The osmotic pressure of polyethylene glycol plus ascorbic acid is approximately twice that of plasma osmolality and may cause dehydration.
  
  
  OBJECTIVE
  In this study, we determined whether dehydration was induced in elderly patients by polyethylene glycol plus ascorbic acid, and we analysed the data obtained in order to identify predictors of dehydration.
  
  
  METHODS
  This was a prospective, uncontrolled, before-and-after intervention study. All patients older than 65 years who underwent colonoscopies at the Moji Medical Center were administered polyethylene glycol plus ascorbic acid prior to colonoscopy. Clinical variables before and after bowel preparation were measured and analysed statistically. A multiple linear regression analysis was performed to identify predictors of dehydration due to this procedure.
  
  
  RESULTS
  Eighty-three patients were assessed for eligibility, and 74 clinical variables were ultimately analysed. A significant increase in the red blood cell count (4.10 versus 4.25 × 10(6)/mm(3)), haemoglobin level (12.4 versus 13.0 g/dL) and haematocrit (38.1% versus 39.4%) suggested the presence of hypovolaemia after the procedure (P < 0.001). The serum concentration of albumin before bowel preparation was identified as the only significant predictor of hypovolaemia (β = 0.47, P = 0.0001, adjusted R (2) = 0.22).
  
  
  CONCLUSIONS
  The serum concentration of albumin before bowel preparation predicted hypovolaemia caused by polyethylene glycol plus ascorbic acid in elderly patients. Therefore, care is needed in order to prevent hypovolaemia, especially in elderly patients with hypoalbuminaemia.
  
  
  BACKGROUND
  No. 000015724 (University Hospital Medical Information Network Center).
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. n-ogino@med.uoeh-u.ac.jp.|Department of Internal Medicine, Moji Medical Center, Kitakyushu, Japan. n-ogino@med.uoeh-u.ac.jp.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Ogino
authors.affiliation: Department of Internal Medicine, Moji Medical Center, Kitakyushu, Japan.|Department of Gastroenterology, Wakamatsu Hospital of University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Gentaro
authors.initials: G
authors.lastname: Aridome
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.|Department of Internal Medicine, Moji Medical Center, Kitakyushu, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Oshima
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Michihiko
authors.initials: M
authors.lastname: Shibata
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Kume
authors.affiliation: Department of Endoscopy, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshikawa
authors.affiliation: Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaoka 1-1, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Harada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D002400:Cathartics / Q000009:adverse effects* / Q000737:chemistry; D003113:Colonoscopy; D003681:Dehydration / Q000139:chemically induced*; D004906:Erythrocyte Count; D005260:Female; D006454:Hemoglobins; D006801:Humans; D008297:Male; D010361:Patients; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D011446:Prospective Studies; D012709:Serum Albumin
chemical_list: D002400:Cathartics; D006454:Hemoglobins; D012709:Serum Albumin; D011092:Polyethylene Glycols; D001205:Ascorbic Acid