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Barium enemas in the frail elderly
J H Gurwitz1, J P Noonan, M Sanchez
1Hebrew Rehabilitation Center for Aged, Boston, Massachusetts.
The American Journal of Medicine
|January 1, 1992
Summary
Barium enema examinations are frequently inadequate in frail elderly patients, with poor bowel preparation being the main issue. Long-term laxative use significantly increases the risk of inadequate barium enemas in this population.
Area of Science:
- Radiology
- Geriatric Medicine
- Gastroenterology
Background:
- Barium enema examinations are crucial for diagnosing gastrointestinal conditions.
- Assessing the quality of barium enemas in the frail elderly is important for accurate diagnosis.
- Previous studies have not adequately addressed the frequency and predictors of inadequate barium enemas in this specific demographic.
Purpose of the Study:
- To determine the frequency of inadequate barium enema examinations in frail elderly patients.
- To identify predictors associated with inadequate barium enema studies in this population.
Main Methods:
- Retrospective review of medical and radiologic records of 171 institutionalized elderly patients (mean age 85.3 years).
- Assessment of the adequacy of barium enema examinations based on radiologist reports.
- Analysis of demographic and clinical factors to identify predictors of inadequate studies.
Main Results:
- 51.5% of barium enema examinations were deemed inadequate.
- Poor bowel preparation was a factor in 89.7% of inadequate studies.
- Long-term laxative and/or cathartic use was significantly associated with inadequate studies (OR = 7.0; 95% CI: 2.7 to 18.0).
Conclusions:
- There is a high frequency of inadequate barium enema examinations in the very old.
- Improved bowel preparation methods are needed for elderly patients undergoing barium enemas.
- Particular attention should be given to long-term laxative users in this population.