Jeffrey Rebhun, MD1, Wilfredo Pagani, 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) is the most validated and reliable measure of bowel preparation cleanliness during the inspection phase of a colonoscopy. Inadequate BBPS scores have been associated with advanced polyp findings at subsequent colonoscopy. This study aims to evaluate how bowel preparation quality, using BBPS, is affected by the day of the week the colonoscopy is performed. Methods: A retrospective review was conducted of all adult patients who underwent outpatient colonoscopy at a tertiary health center between January 2015-April 2020. Patients with a history of colorectal cancer, colonic resection, or whose procedure was aborted due to complications other than poor bowel prep were excluded. All patients received 4-L polyethylene glycol in a split dose. We compared the adequacy of bowel preparation in colonoscopies on Monday or days after a public holiday with those receiving colonoscopies on all other days of the week. A BBPS score of 6 or greater was considered adequate. Secondary outcomes included comparing preparation across patient age, gender, and ethnicity. Statistical analysis was performed using chi-square tests to compare categorical data and one-way ANOVA or Kruskal-Wallis test was used for continuous data, as appropriate. Pearson Correlation Coefficient (PCC) was used to compare the association between BBPS and age. Results: Of 4,279 colonoscopies, 711(16%) occurred on Monday and 132 (3%) after a public holiday. Quality of preparation was significantly associated with the day of the procedure (p< .001). Monday had the highest rate of inadequate preparation (16.5%) and was associated with lower prep quality when compared to other days (p< .001). Males had higher rates of inadequacy compared to females (p=.0032). African Americans had the highest rate (13%) of inadequate preparation among all ethnicities (p< .001). Additionally, bowel preparation quality was found to be inversely correlated with age (PCC =-.077, p< .001). Discussion: Our data suggests that the rate of bowel preparation adequacy on Monday is significantly lower when compared with other days of the week. Patient age, gender, and ethnicity all appear to significantly impact bowel preparation quality. Further understanding of bowel preparation timing and better characterization of procedural and patient variables can lead to a more personalized approach to bowel preparation, potentially increasing the detection of cancerous lesions.
Disclosures: Jeffrey Rebhun indicated no relevant financial relationships. Wilfredo Pagani indicated no relevant financial relationships. Yinglin Xia indicated no relevant financial relationships. Asim Shuja indicated no relevant financial relationships.