Quality indicators in pediatric colonoscopy

Area of Science:

• Pediatric Gastroenterology
• Endoscopy Quality Improvement
• Inflammatory Bowel Disease Diagnostics

Background:

• Ileal intubation is a key quality metric in pediatric colonoscopy, crucial for diagnosing inflammatory bowel disease.
• Achieving high ileal intubation rates (>85%) is essential for comprehensive colonoscopy evaluations.

Purpose of the Study:

• To determine the ileal intubation rate in pediatric colonoscopies.
• To assess factors influencing ileal intubation, including bowel preparation and anesthesia type.

Main Methods:

• An observational, descriptive, cross-sectional study of 99 pediatric colonoscopies in Santiago, Chile (2020-2022).
• Exclusion of procedures not intended for ileal intubation.
• Evaluation of bowel preparation (Boston Bowel Preparation Scale), sedation/anesthesia, and intubation success rates.

Main Results:

• Overall ileal intubation rate was 60.6%, significantly lower than the quality benchmark.
• Ileal intubation rates were 45.8% with sedation versus 82.5% with general anesthesia.
• Boston scale score ≥ 6 (OR: 5.6) and general anesthesia (OR: 11.7) were associated with higher ileal intubation likelihood.

Conclusions:

• Optimizing bowel preparation and utilizing general anesthesia can substantially increase pediatric ileal intubation rates.
• Improving ileal intubation aligns with quality standards and enhances diagnostic efficiency for pediatric gastrointestinal conditions.