Risk Factors and Incidence of Poor Bowel Preparation in Elderly Patients: Prospective Study

Abstract

AIM: The aim of this study was to identify the incidence of and the risk factors for poor bowel preparation in elderly patients. PATIENTS AND METHODS: We enrolled 240 patients over 60 years of age, hospitalized in the Clinic of Gastroenterology, Kaspela University Hospital between October 2016 and May 2017 and scheduled them for colonoscopy. We recorded patients’ demographics data, clinical characteristics and the rate of bowel preparation. Factors associated with poor bowel preparation were identified by multivariate logistical regression analysis. RESULTS: The rate of poor bowel preparation was 33.6%. Factors associated with poor bowel preparation were a history of abdominal surgery (OR, 2.617, CI, 1.324-5.174), chronic constipation (OR, 3.307; CI, 1.551-7.054), non-compliance with dietary instructions (OR, 2.239, CI, 1.122-4.471), noncompliance with polyethylene glycol (PEG) dosage (OR, 4.576, CI, 1.855-11.287), walking less than 30 min during preparation (OR, 2.474; CI, 1.261-4.855), interval between PEG ingestion and the onset of bowel activity (OR, 1.025, CI, 1.010-1.040), the latest stool that was not clear and watery (OR, 4.191; CI, 1.529-11.485). CONCLUSIONS: Elderly patients tend to have suboptimal preparation for colonoscopy. Walking less than 30 min. during the PEG ingestion period may be a surrogate for bowel preparation failure. Future studies should identify patients at risk for poor bowel preparation. Methods and interventions should be developed to improve outcomes.