Risk factors for inadequate bowel preparation: a validated predictive score

Area of Science:

• Gastroenterology
• Clinical Medicine
• Predictive Analytics

Background:

• Inadequate bowel cleansing is a significant issue impacting colonoscopy efficiency.
• Effective colon cleansing is crucial for accurate diagnosis and patient safety during colonoscopy procedures.

Purpose of the Study:

• To develop and validate a predictive model for identifying patients with inadequate bowel cleanliness.
• To identify key factors associated with poor bowel preparation for colonoscopy.

Main Methods:

• A predictive model was developed using data from 667 outpatients (development cohort) and validated on 409 outpatients (validation cohort).
• Bowel cleansing was assessed using the Boston Bowel Preparation Scale (BBPS).
• Multivariate analysis identified independent predictors of inadequate cleansing.

Main Results:

• Antidepressant use, co-morbidity, constipation, and abdominal/pelvic surgery were significant predictors of inadequate bowel preparation.
• The predictive model demonstrated an area under the curve (AUC) of 0.72 in the development cohort and 0.70 in the validation cohort.
• The model achieved a negative predictive value of approximately 89% for predicting adequate bowel preparation.

Conclusions:

• A simple predictive score can assist clinicians in identifying patients at high risk for inadequate bowel cleanliness.
• This tool may guide personalized adjustments to bowel preparation strategies.
• Improving bowel preparation can enhance colonoscopy effectiveness and patient outcomes.