As more and more people rely on colonoscopies for the prevention and early detection of colon cancer, it is crucial that researchers assess the process quality of colonoscopies and identify factors associated with poor quality, specifically in outpatient colonoscopies.
Investigators from the University of Munich in Germany analyzed a database containing details of 145,401 colonoscopies performed by the Compulsory Health Insurance Physicians in Bavaria, Germany from January through September of 2006 for these quality indicators.
Of the patients examined, 110,648 had a clean enough bowel to perform the colonoscopies and only 3,976 examinations were considered incomplete. Most of the examinations (n=134,655) were taken with a sedative. Incomplete exams were largely due to adhesions (scar tissues that attach to the surfaces of organs, n=512), impassable stenosis (narrowing of the gut, n=506), long and curved colon (n=284), and additional complications (n=50). While male and sedated patients were more likely to have a complete colonoscopy, older patients were less likely to complete the procedure.
“For the first time, we report findings for a large range of process quality indicators for outpatient colonoscopies,” said Berndt Birkner, M.D., a gastroenterologist from the Munich study team. “They may serve as a benchmark for comparisons with other programs. Sedation and thorough bowel cleansing are modifiable factors conducive to the completeness of colonoscopies and can play a critical role in the ultimate outcome for these patients.”