Factores asociados a una mala preparación para la colonoscopia

Autores

DOI:

https://doi.org/10.22516/25007440.1001

Palavras-chave:

Colonoscopia, Calidad de la preparación, Factores de riesgo relacionados con la preparación, Escalas de preparación

Resumo

Introducción: una buena preparación intestinal es fundamental para una colonoscopia de calidad. Por eso es importante evaluar los factores de riesgo asociados a una mala preparación. Este problema no se ha abordado ampliamente en Colombia, por lo cual el objetivo de este estudio es identificar los factores asociados a una mala preparación intestinal.

Métodos: estudio observacional, analítico, transversal, multicéntrico en pacientes > 18 años sometidos a colonoscopia que asistieron a los servicios de gastroenterología entre enero y junio de 2020 en la ciudad de Bogotá. Se definió como buena preparación una escala de Boston > 6, y como mala preparación una escala de Boston ≤ 6.

Resultados: se incluyeron a 265 pacientes, de los cuales 205 (77,4%) estaban bien preparados y 60 (22,6%) tenían una preparación inadecuada. Los factores asociados a mala preparación intestinal fueron edad mayor de 60 años (odds ratio [OR]: 1,359; intervalo de confianza [IC] del 95%: 1,059-1,745; p = 0,026); sexo masculino (OR: 1,573; IC 95%: 1,128-2,194; p = 0,012); obesidad (IMC > 30 kg/m2; OR: 2,539; IC 95%: 1,388-4,645; p = 0,002); estreñimiento (OR: 1,924; IC 95%: 1,154-3,208; p = 0,014); el uso de antidepresivos (OR: 2,897; IC 95%: 1,199-6,997; p = 0,014) y antagonistas del calcio (OR: 2,445; IC 95%:1,292-4,630; p = 0,005) y tener cirugías abdominopélvicas (OR: 1,325; IC 95%: 1,042-1,684; p = 0,034). En cuanto al procedimiento, hubo una menor cantidad de detección de pólipos por paciente (p = 0,04) y menor detección de pólipo diminuto (p = 0,020) y plano (p = 0,047) en el grupo de mala preparación intestinal.

Conclusiones: este es el primer estudio en Colombia en el cual se describen los factores asociados a la mala preparación intestinal e incluye variables no exploradas en otros estudios. Los resultados encontrados son similares a los reportados en la literatura. Se debe impulsar este tipo de estudios con una mayor cantidad de pacientes y plantear un puntaje de predicción de mala preparación.

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Biografia do Autor

Martín Alonso Gómez Zuleta, Universidad Nacional de Colombia

Médico internista y gastroenterólogo. Director unidad de gastroenterología. Bogotá, Colombia.

Melissa Bastidas Riascos, Hospital Universitario Nacional de Colombia

Médico internista. Fellow de gastroenterología, Universidad Nacional de Colombia. Bogotá, Colombia.

Oscar Fernando Ruiz Morales, Universidad Nacional de Colombia

Médico internista y gastroenterólogo. Unidad de gastroenterología y ecoendoscopia, UGEC. Hospital de Kennedy. Profesor de Medicina en la Universidad Nacional de Colombia. Bogotá, Colombia.

Marco Adolfo Tobar Marcillo, Universidad Nacional Autónoma de México

Médico internista y reumatólogo. Ciudad de México, México.

Referências

Siegel R, Miller K, et al. Colorectal cancer statistics; CA Cancer J Clin 2020;70(3):145-164. https://doi.org/10.3322/caac.21601

Cortés A, Bravo L, et al. Colorectal cancer incidence, mortality and survival in Cali, Colombia, 1962-2012. 2014;56(5):457-64. https://doi.org/10.21149/spm.v56i5.7371

Bravo L, García L; et al. Reliable information for cancer control in Cali, Colombia. Colomb medica. 2018;49(1):23-34. https://doi.org/10.25100/cm.v49i1.3689

Govani S, Elliott E, et al. Predictors of suboptimal bowel preparation in asymptomatic patients undergoing average-risk screening colonoscopy. World J Gastrointest Endosc. 2016;8(17):616. https://doi.org/10.4253/wjge.v8.i17.616

Guo X, Shi X, et al. Risk Factors Associated with Inadequate Bowel Preparation in Patients with Functional Constipation. Dig Dis Sci. 2020;65(4):1082-91. https://doi.org/10.1007/s10620-019-05847-5

Mahmood S, Farooqui SM, Madhoun MF. Predictors of inadequate bowel preparation for colonoscopy: A systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2018;30(8):819-26. https://doi.org/10.1097/MEG.0000000000001175

Lieberman D, Ladabaum U, et al. Screening for Colorectal Cancer and Evolving Issues for Physicians and Patients: A Review. JAMA. 2016;316(20):2135-45. https://doi.org/10.1001/jama.2016.17418

Zhu L, MingMing Z, et al. Enhanced education for bowel preparation before colonoscopy: a state-of-the-art review. J Dig Dis. 2017;18(2):84-91. https://doi.org/10.1111/1751-2980.12446

Pellisé M. Colonoscopia en el cribado, seguimiento y tratamiento del cáncer colorrectal y sus lesiones precursoras. Gastroenterol Hepatol. 2015;388(1):71-7. https://doi.org/10.1016/S0210-5705(15)30022-4

Dekker E, Tanis PJ, et al. Colorectal cancer. Lancet 2019;394(10207):1467-80. https://doi.org/10.1016/S0140-6736(19)32319-0

Parekh PJ, Oldfield EC, Johnson DA. Bowel preparation for colonoscopy: What is best and necessary for quality? Curr Opin Gastroenterol. 2019;35(1):51-7. https://doi.org/10.1097/MOG.0000000000000494

Hassan C, East J, Radaelli F et al. Bowel preparation for colonoscopy: European society of gastrointestinal endoscopy (ESGE) guideline-update 2019. Endoscopy. 2019;51(8):775-94. https://doi.org/10.1055/a-0959-0505

Zhang Y, Niu M et al. The incidence of and risk factors for inadequate bowel preparation in elderly patients: A prospective observational study. Saudi J Gastroenterol. 2018;24(2):87-92. https://doi.org/10.4103/sjg.SJG_426_17

Gimeno A, Baute J et al. Risk factors for inadequate bowel preparation: A validated predictive score. Endoscopy. 2017;49(6):536-43. https://doi.org/10.1055/s-0043-101683

Jhonson D, Barkun A, Cohen L, et al. Optimizing adequacy of bowel cleansing for colonoscopy: recommendations from the US multi-society task force on colorectal cancer. Gastroenterology. 2014;1147(4):903-24. https://doi.org/10.1053/j.gastro.2014.07.002

Kastenberg D, Bertiger G, Brogadir S. Bowel preparation quality scales for colonoscopy. World J Gastroenterol. 2018;24(26):2833-43. https://doi.org/10.3748/wjg.v24.i26.2833

Fanjul I, Lasa J, et al. Factores relacionados al paciente que afectan la limpieza del colon previo a la colonoscopía. Acta Gastroenterol Latinoam. 2016;46(1):18-21.

Garber A, Sarvepalli S, et al. Modifiable factors associated with quality of bowel preparation among hospitalized patients undergoing colonoscopy. Vol. 14, Journal of Hospital Medicine. 2019: 278-83. https://doi.org/10.12788/jhm.3173

Bugajski M, WIeszczy P, et al. Modifiable factors associated with patient- reported pain during and after screening colonoscopy. Gut. 2018;67(11):1958-64. https://doi.org/10.1136/gutjnl-2017-313905

Anderson JC, Baron JA, et al. Factors Associated With Shorter Colonoscopy Surveillance Intervals for Patients With Low-Risk Colorectal Adenomas and Effects on Outcome. Gastroenterology. 2017 ;152(8):1933- 1943.e5. https://doi.org/10.1053/j.gastro.2017.02.010

Harewood G, Sharma V, Garmo P. Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia. Gastrointest. Endosc.2003 58(1):76-9. https://doi.org/10.1067/mge.2003.294

Sulz M, Kroger A, et al. Meta-Analysis of the Effect of Bowel Preparation on Adenoma detection: Early adenomas affected stronger than advanced adenomas. PLoS One .2016;6:11 https://doi.org/10.1371/journal.pone.0154149

Clark BT, Protiva P et al. Quantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men. Gastroenterology. 2016 Feb 1;150(2):396-405. https://doi.org/10.1053/j.gastro.2015.09.041

Dik VK, Moons LMG, et al. Predicting inadequate bowel preparation for colonoscopy in participants receiving split-dose bowel preparation: Development and validation of a prediction score. Gastrointest Endosc. 2015;81(3):665-72. https://doi.org/10.1016/j.gie.2014.09.066

Paik N, Kim ER, et al. Usefulness of personal bowel habits as a predictive factor for inadequate bowel preparation for colonoscopy: A prospective questionnaire-based observational study. Gut and Liver. 2019; 13:169-75. https://doi.org/10.5009/gnl18236

Wong MCS, Ching JYL, et al. Determinants of bowel preparation quality and its association with adenoma detection: A prospective colonoscopy study. Med (United States). 2016;95(2):1-8. https://doi.org/10.1097/MD.0000000000002251

Amitay EL, Niedermaier T et al. Risk factors of inadequate bowel preparation for screening colonoscopy. J Clin Med. 2021;10(12):2740. https://doi.org/10.3390/jcm10122740

Gandhi K, Tofani C, et al. Patient characteristics associated with quality of colonoscopy preparation: A systematic review and meta-analysis. Clin Gastroenterol Hepatol.2018;16(3):357-369.e10. https://doi.org/10.1016/j.cgh.2017.08.016

Hassan C, Fuccio L, Bruno M, et al. A predictive model identifies patients most likely to have inadequate bowel preparation for colonoscopy. Clin Gastroenterol Hepatol. 2012;10(5):501-6. https://doi.org/10.1016/j.cgh.2011.12.037

Gralnek IM, Hassan C, et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy. 2020;52(6):483-90. https://doi.org/10.1055/a-1155-6229

Yadlapati R, Jhonston E et al. Predictors of inadequate inpatient colonoscopy preparation and its association with Hospital length of stay and costs. Dig Dis Sci.2015; 60(11):3482-90. https://doi.org/10.1007/s10620-015-3761-2

Doykov D, Andonov V, et al; Risk factors and incidence of poor bowel preparation in elderly patients: Prospective Study. 2019; 61:370-6. https://doi.org/10.3897/folmed.61.e39409

Fitzpatrick-Lewis D, Ali MU, Warren R, et al. Screening for colorectal cancer: A systematic review and meta-Analysis. Clin colorectal cancer. 2016;15(4):298-313. https://doi.org/10.1016/j.clcc.2016.03.003

Repici A, Badalamenti M, et al. Efficacy of real-time computer-aided detection of colorectal neoplasia in a randomized trial. Gastroenterology. 2020;159(2):512-520.e7. https://doi.org/10.1053/j.gastro.2020.04.062

Lebwohl B, Kastrinos F, et al. The impact of suboptimal bowel preparation on adenoma miss rates and the factors associated with early repeat colonoscopy. Gastrointest Endosc. 2011 Jun;73(6):1207-14. https://doi.org/10.1016/j.gie.2011.01.051

Tabla 3. Factores derivados del procedimiento endoscópico asociadas con la preparación intestinal

Publicado

2023-09-27

Como Citar

Gómez Zuleta, M. A., Bastidas Riascos, M., Ruiz Morales, O. F., & Tobar Marcillo, M. A. (2023). Factores asociados a una mala preparación para la colonoscopia. Revista Colombiana De Gastroenterologia, 38(3), 311–320. https://doi.org/10.22516/25007440.1001

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