Compliance with Quality Standards and Causes of Incomplete Colonoscopy: A Prospective Observational Study

Abstract

Aim: To evaluate incomplete colonoscopy rate, factors affecting incomplete colonoscopy, and compliance with colonoscopy quality standards in our clinic. Method: This prospective study was conducted in a tertiary health center between January 2017 and December 2017. Demographic characteristics of individuals undergoing colonoscopy, their colon cleansing status, causes of incomplete colonoscopy, and factors affecting incomplete colonoscopy were investigated. Results: A total of 756 people were included in this study. The mean age was 54±12.74 years and 63% of the patients were female. Mean body mass index (BMI) was 28.32±4.84 and 309 (40.9%) had history of prior abdominal surgery. The duration of cecal intubation was 355±187 seconds and colonoscopy could not be completed in 89 patients (11.8%). Advanced age (p=0.036), female gender (p=0.036), high BMI values (p=0.042), presence of comorbidity (p=0.004), antiaggregant/anticoagulant use (p=0.001), and inadequate bowel cleansing (p<0.001) were found to be significant factors for incomplete colonoscopy. Excluding the patients who had inadequate colon cleansing and were recommended to repeat the procedure, colonoscopy was completed in 93.9% (667/710) of patients. Inadequate bowel preparation was the most common cause of incomplete colonoscopy (51.6%) and male gender (p=0.047), antiaggregant/anticoagulant use (p=0.021) were identified as factors affecting colon cleansing. Polyp detection rate was 24.7% (165/667), below the currently recommended rate of detection of adenoma. Conclusion: Inadequate bowel preparation, advanced age, female gender, high BMI, presence of comorbidity, use of antiaggregant/anticoagulant are risk factors for incomplete colonoscopy. We are below colonoscopy quality standards due to high incomplete colonoscopy rate and low adenoma detection rate due to inadequate bowel preparation.

Keywords

• Incomplete colonoscopy
• bowel preparation
• quality in colonoscopy