Association between body mass index and quality of split bowel preparation

Nabil Fayad, Charles Kahi, Khaled H. Abd El-Jawad, Andrea Shin, Shenil Shah, Kathleen A. Lane, Thomas Imperiale

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background & Aims: Little is known about the association between obesity and bowel preparation. We investigated whether body mass index (BMI) is an independent risk factor for inadequate bowel preparation in patients who receive split preparation regimens. Methods: We performed a retrospective study of data from 2163 consecutive patients (mean age, 60.6 ± 10.5 y; 93.8% male) who received outpatient colonoscopies in 2009 at the Veterans Affairs Medical Center in Indianapolis, Indiana. All patients received a split preparation, categorized as adequate (excellent or good, based on the Aronchick scale) or inadequate. We performed a multivariable analysis to identify factors independently associated with inadequate preparation. Results: Bowel preparation quality was inadequate for 44.2% of patients; these patients had significantly higher mean BMIs than patients with adequate preparation (31.2 ± 6.5 vs 29.8 ± 5.9, respectively; P <.0001) and Charlson comorbidity scores (1.5 ± 1.6 vs 1.1 ± 1.4; P <.0001). Independent risk factors for inadequate preparation were a BMI of 30 kg/m2 or greater (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.21-1.75; P <.0001), use of tobacco (OR, 1.28; 95% CI, 1.07-1.54; P=.0084) or narcotics (OR, 1.28; 95% CI, 1.04-1.57; P=.0179), hypertension (OR, 1.30; 95% CI, 1.07-1.57; P=.0085), diabetes (OR, 1.38; 95% CI, 1.12-1.69; P=.0021), and dementia (OR, 3.02; 95% CI, 1.22-7.49; P=.0169). Conclusions: BMI is an independent factor associated with inadequate split bowel preparation for colonoscopy. Additional factors associated with quality of bowel preparation include diabetes, hypertension, dementia, and use of tobacco and narcotics. Patients with BMIs of 30 kg/m2 or greater should be considered for more intensive preparation regimens.

Original languageEnglish
Pages (from-to)1478-1485
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume11
Issue number11
DOIs
StatePublished - Nov 2013

Fingerprint

Body Mass Index
Odds Ratio
Confidence Intervals
Narcotics
Tobacco Use
Colonoscopy
Dementia
Hypertension
Veterans
Comorbidity
Outpatients
Retrospective Studies
Obesity

Keywords

  • Adenoma Detection
  • Colonoscopy Preparation
  • Colorectal Cancer Screening
  • Overweight

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Association between body mass index and quality of split bowel preparation. / Fayad, Nabil; Kahi, Charles; Abd El-Jawad, Khaled H.; Shin, Andrea; Shah, Shenil; Lane, Kathleen A.; Imperiale, Thomas.

In: Clinical Gastroenterology and Hepatology, Vol. 11, No. 11, 11.2013, p. 1478-1485.

Research output: Contribution to journalArticle

@article{aaa8ba20859041d3ba6db9fa99fe6904,
title = "Association between body mass index and quality of split bowel preparation",
abstract = "Background & Aims: Little is known about the association between obesity and bowel preparation. We investigated whether body mass index (BMI) is an independent risk factor for inadequate bowel preparation in patients who receive split preparation regimens. Methods: We performed a retrospective study of data from 2163 consecutive patients (mean age, 60.6 ± 10.5 y; 93.8{\%} male) who received outpatient colonoscopies in 2009 at the Veterans Affairs Medical Center in Indianapolis, Indiana. All patients received a split preparation, categorized as adequate (excellent or good, based on the Aronchick scale) or inadequate. We performed a multivariable analysis to identify factors independently associated with inadequate preparation. Results: Bowel preparation quality was inadequate for 44.2{\%} of patients; these patients had significantly higher mean BMIs than patients with adequate preparation (31.2 ± 6.5 vs 29.8 ± 5.9, respectively; P <.0001) and Charlson comorbidity scores (1.5 ± 1.6 vs 1.1 ± 1.4; P <.0001). Independent risk factors for inadequate preparation were a BMI of 30 kg/m2 or greater (odds ratio [OR], 1.46; 95{\%} confidence interval [CI], 1.21-1.75; P <.0001), use of tobacco (OR, 1.28; 95{\%} CI, 1.07-1.54; P=.0084) or narcotics (OR, 1.28; 95{\%} CI, 1.04-1.57; P=.0179), hypertension (OR, 1.30; 95{\%} CI, 1.07-1.57; P=.0085), diabetes (OR, 1.38; 95{\%} CI, 1.12-1.69; P=.0021), and dementia (OR, 3.02; 95{\%} CI, 1.22-7.49; P=.0169). Conclusions: BMI is an independent factor associated with inadequate split bowel preparation for colonoscopy. Additional factors associated with quality of bowel preparation include diabetes, hypertension, dementia, and use of tobacco and narcotics. Patients with BMIs of 30 kg/m2 or greater should be considered for more intensive preparation regimens.",
keywords = "Adenoma Detection, Colonoscopy Preparation, Colorectal Cancer Screening, Overweight",
author = "Nabil Fayad and Charles Kahi and {Abd El-Jawad}, {Khaled H.} and Andrea Shin and Shenil Shah and Lane, {Kathleen A.} and Thomas Imperiale",
year = "2013",
month = "11",
doi = "10.1016/j.cgh.2013.05.037",
language = "English",
volume = "11",
pages = "1478--1485",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "11",

}

TY - JOUR

T1 - Association between body mass index and quality of split bowel preparation

AU - Fayad, Nabil

AU - Kahi, Charles

AU - Abd El-Jawad, Khaled H.

AU - Shin, Andrea

AU - Shah, Shenil

AU - Lane, Kathleen A.

AU - Imperiale, Thomas

PY - 2013/11

Y1 - 2013/11

N2 - Background & Aims: Little is known about the association between obesity and bowel preparation. We investigated whether body mass index (BMI) is an independent risk factor for inadequate bowel preparation in patients who receive split preparation regimens. Methods: We performed a retrospective study of data from 2163 consecutive patients (mean age, 60.6 ± 10.5 y; 93.8% male) who received outpatient colonoscopies in 2009 at the Veterans Affairs Medical Center in Indianapolis, Indiana. All patients received a split preparation, categorized as adequate (excellent or good, based on the Aronchick scale) or inadequate. We performed a multivariable analysis to identify factors independently associated with inadequate preparation. Results: Bowel preparation quality was inadequate for 44.2% of patients; these patients had significantly higher mean BMIs than patients with adequate preparation (31.2 ± 6.5 vs 29.8 ± 5.9, respectively; P <.0001) and Charlson comorbidity scores (1.5 ± 1.6 vs 1.1 ± 1.4; P <.0001). Independent risk factors for inadequate preparation were a BMI of 30 kg/m2 or greater (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.21-1.75; P <.0001), use of tobacco (OR, 1.28; 95% CI, 1.07-1.54; P=.0084) or narcotics (OR, 1.28; 95% CI, 1.04-1.57; P=.0179), hypertension (OR, 1.30; 95% CI, 1.07-1.57; P=.0085), diabetes (OR, 1.38; 95% CI, 1.12-1.69; P=.0021), and dementia (OR, 3.02; 95% CI, 1.22-7.49; P=.0169). Conclusions: BMI is an independent factor associated with inadequate split bowel preparation for colonoscopy. Additional factors associated with quality of bowel preparation include diabetes, hypertension, dementia, and use of tobacco and narcotics. Patients with BMIs of 30 kg/m2 or greater should be considered for more intensive preparation regimens.

AB - Background & Aims: Little is known about the association between obesity and bowel preparation. We investigated whether body mass index (BMI) is an independent risk factor for inadequate bowel preparation in patients who receive split preparation regimens. Methods: We performed a retrospective study of data from 2163 consecutive patients (mean age, 60.6 ± 10.5 y; 93.8% male) who received outpatient colonoscopies in 2009 at the Veterans Affairs Medical Center in Indianapolis, Indiana. All patients received a split preparation, categorized as adequate (excellent or good, based on the Aronchick scale) or inadequate. We performed a multivariable analysis to identify factors independently associated with inadequate preparation. Results: Bowel preparation quality was inadequate for 44.2% of patients; these patients had significantly higher mean BMIs than patients with adequate preparation (31.2 ± 6.5 vs 29.8 ± 5.9, respectively; P <.0001) and Charlson comorbidity scores (1.5 ± 1.6 vs 1.1 ± 1.4; P <.0001). Independent risk factors for inadequate preparation were a BMI of 30 kg/m2 or greater (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.21-1.75; P <.0001), use of tobacco (OR, 1.28; 95% CI, 1.07-1.54; P=.0084) or narcotics (OR, 1.28; 95% CI, 1.04-1.57; P=.0179), hypertension (OR, 1.30; 95% CI, 1.07-1.57; P=.0085), diabetes (OR, 1.38; 95% CI, 1.12-1.69; P=.0021), and dementia (OR, 3.02; 95% CI, 1.22-7.49; P=.0169). Conclusions: BMI is an independent factor associated with inadequate split bowel preparation for colonoscopy. Additional factors associated with quality of bowel preparation include diabetes, hypertension, dementia, and use of tobacco and narcotics. Patients with BMIs of 30 kg/m2 or greater should be considered for more intensive preparation regimens.

KW - Adenoma Detection

KW - Colonoscopy Preparation

KW - Colorectal Cancer Screening

KW - Overweight

UR - http://www.scopus.com/inward/record.url?scp=84885854796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885854796&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2013.05.037

DO - 10.1016/j.cgh.2013.05.037

M3 - Article

C2 - 23811246

AN - SCOPUS:84885854796

VL - 11

SP - 1478

EP - 1485

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 11

ER -