The diagnostic yield of colonoscopy in hospitalized patients. An observational multicenter prospective study. |
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| Authors: | Leonardo Frazzoni Franco Radaelli Cristiano Spada Alessandro Mussetto Marzio Frazzoni Liboria Laterza Emanuele Rondonotti Marina La Marca Rocco Maurizio Zagari Stefania Piccirelli Franco Bazzoli Carlo Fabbri Mauro Manno Giovanni Aragona Gianpiero Manes Pietro Occhipinti Sergio Cadoni Cesare Hassan Lorenzo Fuccio |
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| Institution: | 1. Gastroenterology Unit, Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;2. Gastroenterology Unit, Valduce Hospital, Como, Italy;3. Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy;4. Gastroenterology Unit, S. Maria delle Croci Hospital, Ravenna, Italy;5. Department of Specialized Medicine, Digestive Pathophysiology Unit, Baggiovara Hospital, Modena, Italy;6. Unit of Gastroenterology and Digestive Endoscopy, Forli-Cesena Hospital, AUSL Romagna, Forli-Cesena, Italy;7. UOSD Gastroenterologia ed Endoscopia Digestiva, Azienda USL di Modena, Italy;8. Department of Internal Medicine, Gastroenterology and Hepatology Unit, \"Guglielmo da Saliceto\" Hospital, Via Taverna 49, Piacenza, Italy;9. Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy;10. Gastroenterology and Digestive Endoscopy Unit, Ospedale Maggiore della Carità, Novara, Italy;11. Digestive Endoscopy Unit, Centro Traumatologico-Ortopedico Hospital, Iglesias, Italy;12. Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy |
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| Abstract: | BackgroundColonoscopy demands a considerable amount of resources, and little is known about its diagnostic yield among inpatients.AimsTo assess indications, diagnostic yield and findings of colonoscopy for inpatients, and to identify risk factors for relevant findings and cancer.MethodsMulticentre, prospective, observational study including 12 hospitals. Consecutive adult inpatients undergoing colonoscopy were evaluated from February through November 2019.Results1,302 inpatients underwent colonoscopy. Diagnostic yield for relevant findings and cancer was 586 (45%) and 112 (8.6%), respectively. Adequate colon cleansing was achieved in 896 (68.8%) patients. Split-dose/same-day regimen was adopted in 847 (65%) patients. Factors associated to relevant findings were age ≥70 years (RR 1.32), male gender (RR 1.11), blood loss (RR 1.22) and adequate cleansing (RR 1.63). Age ≥70 years (RR 2.08), no previous colonoscopy (RR 2.69) and split-dose/same-day regimen (RR 1.59) significantly increased cancer detection. Implementing adequate cleansing and split-dose/same-day regimen in all patients would increase the diagnostic yield for any relevant findings and cancer from 43% to 70% and from 6% to 10%, respectively.ConclusionRelevant colorectal diseases and cancer were frequent among inpatients. Factors associated with detection of relevant findings were identified. Adequate colon cleansing and split-dose/same-day regimen significantly increased colonoscopy diagnostic yield. |
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