Jeffrey Rebhun, MD1, Yinglin Xia, PhD, MS1, Asim Shuja, MD2; 1University of Illinois at Chicago, Chicago, IL; 2University of Illinois College of Medicine, Chicago, IL
Introduction: The Boston Bowel Preparation Scale (BBPS) offers the most validated measure of bowel preparation cleanliness during colonoscopy. Historically, bowel preparation for morning (AM) colonoscopies has been shown to be of higher quality when compared to afternoon (PM) colonoscopies. However, substantial advances in prep quality and patient tolerability have not been accounted for in these limited studies. This study aims to evaluate how bowel preparation quality, using the BBPS, is affected by the timing of the procedure. Methods: A retrospective review was conducted of all adult patients who underwent outpatient colonoscopy at a tertiary health center between January 2015-April 2020. The standard bowel preparation used by our practice during that period of time was the 4-L polyethylene glycol in a split dose. Patients were instructed to finish their second dose of preparation exactly 4 h prior to their scheduled procedure time which set up the runway time within optimal limits. Patients were grouped as either having scheduled AM or PM colonoscopies. Secondary objectives included comparing BBPS across patient age, gender, and ethnicity. Additionally, rates of adequacy and inadequacy were compared among groups. Statistical analysis was performed using chi-square tests to compare categorical data and one-way ANOVA or Kruskal-Wallis for continuous data. Pearson correlation analysis was used to compare BBPS and age. Results: Of 4,279 colonoscopies, 2430 (57%) were conducted in the AM and 1849 (43%) in the PM. BBPS scores in the AM (7.31 + 1.74) were not significantly different than scores in the PM (7.33 + 1.69, p=.664). There was no difference among adequate or inadequate prep scores when comparing AM with PM colonoscopies (p=.498). Female BBPS was significantly higher than male BBPS (p< .001) and more adequate than male bowel preparation (p=.0032). African Americans had the lowest BBPS and the highest rate (13%) of inadequate scores among all ethnicities (p< .001). Additionally, BBPS was inversely correlated with age (PCC =-.077, p< .001) Discussion: Our data suggests that bowel preparation quality is similar among morning and afternoon colonoscopies. Additionally, patient age, gender, and ethnicity appear to significantly impact bowel preparation quality. A further understanding of bowel preparation timing and better characterization of associated patient variables can lead to a personalized approach to bowel preparation.
Disclosures: Jeffrey Rebhun indicated no relevant financial relationships. Yinglin Xia indicated no relevant financial relationships. Asim Shuja indicated no relevant financial relationships.