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Factors associated with incomplete small bowel capsule endoscopy studies

World Journal of Gastroenterology 2010年第42期16卷 5329-5333页

作者： Mitchell M Lee Andrew Jacques Eric Lam Ricky Kwok Pardis Lakzadeh Ajit Sandhar Brandon Segal sigrid svarta Joanna Law Robert Enns St Paul's Hospital University of British Columbia770-1190 Hornby StreetVancouverBritish Columbia V6Z 2K5Canada

AIM:To identify patient risk factors associated with incomplete small bowel capsule endoscopy(CE) ***:Data from all CE procedures performed at ***'s Hospital in Vancouver,British Columbia,Canada,between December 2001 and June 2008 were collected and analyzed on a retrospective *** collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure,hospitalization,diabetes mellitus with or without end organ damage,limitations in mobility,renal insufficiency,past history of bowel obstruction,abdominal surgery,abdominal radiation therapy and opiate *** factors were analyzed using a univariable and multivariable logistic regression ***:From a total of 535 CE procedures performed,158 were incomplete(29.5%).The univariable analysis showed that CE procedures performed for overt gastrointestinal bleeding(P = 0.002),and for patients with a prior history of abdominal surgery(P = 0.023) or bowel obstruction(P = 0.023) were significantly associated with incomplete CE *** on opiate medications(P = 0.094) as well as hospitalized patients(P = 0.054) were not statistically significant,but did show a trend towards incomplete *** multivariable analysis showed that independent risk factors for an incomplete CE procedure include prior history of bowel obstruction [odds ratios(OR) 2.77,P = 0.02,95% confidence intervals(CI):1.17-6.56] and procedures performed for gastrointestinal bleeding(Occult OR 2.04,P = 0.037,95% CI:1.04-4.02 and Overt OR 2.69,P = 0.002,95% CI:1.44-5.05).Patients with a prior history of abdominal surgery(OR 1.46,P = 0.068,95% CI:0.97-2.19),those taking opiate medications(OR 1.54,P = 0.15,95% CI:0.86-2.76) and hospitalized patients(OR 1.82,P = 0.124,95% CI:0.85-3.93) showed a trend towards statistical ***:We have identified a number of risk factors for incomplete CE procedures

关键词： Capsule Capsule endoscopy Incomplete endoscopy

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Identification of factors associated with sedation tolerance in 5000 patients undergoing outpatient colonoscopy:Canadian tertiary center experience

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 770-776页

作者： Alexandra Shingina George Ou Oliver Takach sigrid svarta Ricky Kwok Jessica Tong Kieran Donaldson Eric Lam Robert Enns Department of Gastroenterology Faculty of MedicineUniversity of TorontoToronto General Hospital Department of Gastroenterology Faculty of MedicineUniversity of British Columbia Division of Gastroenterology Saint Paul Hospital

AIM To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during *** A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at ***'s Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of *** predictor variables including age,gender,endoscopy indication,high sedation requirements during previous endoscopies,difficulty of the procedure,bowel preparation quality,interventions,findings as well as current use of benzodiazepines,opioids and alcohol were *** outcome of study was the use ofhigh dose of sedation agents for the *** particular,the high dose of sedation was defined as fentanyl greater than 50 mcg and midazolam greater than 3 *** Analysis of 5282 patients(mean age 57 ± 12,49% female) was *** common indication for the procedure was screening colonoscopy(57%).Almost half of our patients received doses exceeding Fentanyl 50 mcg and Midazolam 3 *** regression models identified the following variables associated with high sedation:Younger age(OR=0.95 95%CI:0.94-0.95;P < 0.0001);abdominal pain(OR=1.45,95%CI:1.08-1.96);P=0.01) and Inflammatory Bowel Disease(OR=1.45,95%CI:1.04-2.03;P=0.02) as indications for the procedure;difficult procedure as defined by gastroenterologist(OR=1.73,95%CI:1.48-2.03;P < 0.0001);past history of abdominal surgery(OR=1.33,95%CI:1.17-1.52;P <0.0001) and previous colonoscopy(OR=1.39,95%CI:1.21-1.60;P=0.0001) and alcohol use(OR=1.26,95%CI:1.03-1.54;P=0.02).Age and gender adjusted analysis yielded inflammatory bowel disease as an indication(OR=3.17,95%CI:1.58-6.37;P=0.002);difficult procedure as defined by an endoscopist(OR=5.13 95%CI:2.97-8.85;P=0.0001) and current use of opioids,benzodiazepines or antidepressants(OR=2.88,95%CI:1.74-4.77;P=0.001) having the highest predictive value of high sedation require

关键词： Colonoscopy Sedation Sedation tolerance Fentanyl Midazolam Predictive model

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