Risk factors associated with longer cecal intubation time: a systematic review and meta-analysis.

Area of Science:

• Gastroenterology
• Medical Informatics

Background:

• Cecal intubation time (CIT) is a key indicator of colonoscopy difficulty.
• Prolonged CIT is linked to patient discomfort and increased complication risks.
• Previous studies on CIT predictors were limited by small sample sizes and inconsistent findings.

Purpose of the Study:

• To systematically review and perform a meta-analysis of available data to identify predictors of prolonged cecal intubation time (CIT).
• To consolidate evidence from multiple studies to provide a more robust understanding of factors influencing colonoscopy duration.

Main Methods:

• A systematic literature search of MEDLINE and EMBASE databases was conducted up to November 2017.
• Factors reported in at least three studies were included in the meta-analyses.
• Random effects models were used to calculate pooled mean differences and 95% confidence intervals, with heterogeneity assessed using Q statistic and I².

Main Results:

• Nine studies comprising 7131 patients were analyzed.
• Older age (≥65 years), female sex, low body mass index (<25 kg/m²), and poor bowel preparation were significantly associated with longer CIT.
• Diverticulosis and prior abdominal surgery did not show a significant association with prolonged CIT.

Conclusions:

• Old age, female sex, low BMI, and poor bowel preparation are significant predictors of prolonged cecal intubation time.
• These findings can inform strategies to anticipate and potentially mitigate difficult colonoscopies.