title: Preassessment Interview Improves the Efficacy and Safety of Bowel Preparation for Colonoscopy.
abstract: Aim. To determine whether preassessment improves bowel preparation quality and prevents renal deterioration for chronic kidney disease (CKD) patients.Methods. Data was collected prospectively starting in January 2011 for 12 months. Patients were divided according to the presence or absence of preassessment and stratified to one of three risk groups based on patient's comorbidities and identified risk factors for poor bowel preparation; group 1 had no risk factors, group 2 had 1 risk factor, and group 3 patients had 2 or more risk factors. The association between preassessment and bowel preparation quality was analyzed using binary logistic regression.Results. 1840 colonoscopies were carried out during the period. Total number analyzed was 1704. 404 patients were preassessed. Preassessment patients had significantly better bowel preparation across all groups (OR 1.605;p= 0.002). Group 3 patients were 52% more likely to have good bowel preparation (p= 0.04) if they had been preassessed. Eighty-eight patients were identified with an eGFR < 60 mL/min. There was a significant difference in the eGFR percentage change between patients with preassessment and those without (p= 0.006).Conclusions. Face-to-face preassessment appears to improve the quality of bowel preparation and aids in minimizing the risk of renal injury in patients with CKD.
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Hari
authors.identifier: 0000-0003-1910-6238
authors.initials: H
authors.lastname: Padmanabhan
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rothnie
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Andy
authors.initials: A
authors.lastname: Higgins
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Amandeep
authors.initials: A
authors.lastname: Grewal
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Arndtz
authors.affiliation: Research Institute of Healthcare Sciences, University of Wolverhampton, Wolverhampton, UK.
authors.forename: Alan M
authors.identifier: 0000-0003-0506-3652
authors.initials: AM
authors.lastname: Nevill
authors.affiliation: Gastroenterology Unit, New Cross Hospital, Wolverhampton, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Brookes
authors.affiliation: Gastroenterology Unit, County Hospital, Stafford, UK.
authors.forename: Ray
authors.initials: R
authors.lastname: Mathew
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D002400:Cathartics / Q000009:adverse effects*; D003113:Colonoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
chemical_list: D002400:Cathartics