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Related Experiment Videos

Predictors of incomplete flexible sigmoidoscopy.

Kalyanakrishnan Ramakrishnan1, Dewey C Scheid

  • 1Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, 73104, USA. kramakrishnan@ouhsc.edu

The Journal of the American Board of Family Practice
|February 14, 2004
PubMed
Summary

Flexible sigmoidoscopy (flex sig) completion is affected by patient factors. Inadequate bowel prep and hysterectomy impact women, while older age, abdominal surgery, and weight loss affect men, influencing polyp and cancer detection.

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Area of Science:

  • Gastroenterology
  • Colorectal Cancer Screening
  • Medical Diagnostics

Background:

  • Flexible sigmoidoscopy (flex sig) is a common outpatient screening tool for colorectal polyps and cancer.
  • Incomplete insertion depth during flex sig can lead to missed diagnoses of polyps and cancers.
  • Identifying factors predictive of insertion depth is crucial for patient selection and optimizing screening strategies.

Purpose of the Study:

  • To analyze factors influencing the depth of insertion during flexible sigmoidoscopy in an outpatient setting.
  • To identify patient characteristics associated with incomplete examinations.
  • To inform prospective patient selection for flexible sigmoidoscopy.

Main Methods:

  • Retrospective chart review of flexible sigmoidoscopy procedures performed by a single endoscopist over three years.

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  • Analysis of variables potentially affecting the depth of sigmoidoscope insertion.
  • Development of separate logistic regression models for men and women due to sex as an effect modifier.

    • Main Results:

    • In women, incomplete insertion was linked to inadequate bowel preparation (OR 3.59) and hysterectomy (OR 6.89 for <70 years).
    • In men, incomplete insertion was associated with age over 75 (OR 6.51), history of abdominal surgery (OR 3.15), and weight loss (OR 9.62).
    • Women accounted for over 75% of incomplete examinations.

    Conclusions:

    • Patient factors including age, sex, prior hysterectomy, abdominal surgery, weight loss, and bowel preparation quality influence flexible sigmoidoscopy completion.
    • Further research is needed to develop a predictive model for patient selection for flex sig.
    • For patients with anticipated difficulty, options include sedation, analgesia, distraction techniques, or primary colonoscopy.