Retrospective Study
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World J Gastroenterol. Jun 14, 2014; 20(22): 6961-6967
Published online Jun 14, 2014. doi: 10.3748/wjg.v20.i22.6961
Factors associated with incomplete colonoscopy at a Japanese academic hospital
Shigeo Koido, Toshifumi Ohkusa, Kosaburo Nakae, Tetsuji Yokoyama, Tomoyoshi Shibuya, Naoto Sakamoto, Kan Uchiyama, Hiroshi Arakawa, Taro Osada, Akihito Nagahara, Sumio Watanabe, Hisao Tajiri
Shigeo Koido, Toshifumi Ohkusa, Kan Uchiyama, Hiroshi Arakawa, Hisao Tajiri, Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Chiba 277-8567, Japan
Kosaburo Nakae, Tomoyoshi Shibuya, Naoto Sakamoto, Taro Osada, Akihito Nagahara, Sumio Watanabe, Department of Gastroenterology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
Tetsuji Yokoyama, Department of Technology Assessment and Biostatistics, National Institute of Public Health, Saitama 351-0197, Japan
Author contributions: Koido S, Ohkusa T, Nakae K, Yokoyama T, Watanabe S and Tajiri H designed the research; Koido S, Ohkusa T, Nakae K, Yokoyama T, Shibuya T, Sakamoto N, Uchiyama K, Arakawa H, Osada T and Nagahara A performed the research; and Koido S, Ohkusa T, Nakae K and Yokoyama T analyzed the data and wrote the paper.
Supported by Grants in Aid for Scientific Research (C) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology
Correspondence to: Toshifumi Ohkusa, MD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, The Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba 277-8567, Japan. ohkusa@jikei.ac.jp
Telephone: +81-4-71641111 Fax:+81-4-71633488
Received: November 6, 2013
Revised: January 22, 2014
Accepted: March 19, 2014
Published online: June 14, 2014
Processing time: 220 Days and 22.6 Hours
Abstract

AIM: To evaluate significant risk factors for incomplete colonoscopy at a Japanese academic hospital.

METHODS: A total of 11812 consecutive Japanese people were identified who underwent a colonoscopy at an academic hospital. A multiple logistic regression model was used to evaluate retrospectively the significant risk factors for incomplete colonoscopy.

RESULTS: The cecal intubation rate was 95.0%. By univariate analysis, age, female sex, poor bowel cleansing, and a history of abdominal or pelvic surgery were significant risk factors for incomplete colonoscopy (P < 0.001). Moreover, age- and sex-adjusted analysis showed that significant risk factors for incomplete colonoscopy were female sex (OR = 1.38, 95%CI: 1.17-1.64, P = 0.0002), age ≥ 60 years old (OR = 1.44, 95%CI: 1.22-1.71, P < 0.0001), a history of prior abdominal or pelvic surgery (OR = 1.55, 95%CI: 1.28-1.86, P < 0.0001), poor bowel cleansing (OR = 4.64, 95%CI: 3.69-5.84, P < 0.0001), and inflammatory bowel disease (IBD) (OR = 1.48, 95%CI: 1.13-1.95, P = 0.0048). In Japanese men, by age-adjusted analysis, IBD (OR = 1.69, 95%CI: 1.18-2.43, P = 0.005) was an independent risk factor for incomplete colonoscopy.

CONCLUSION: Several characteristics in the Japanese population were identified that could predict technical difficulty with colonoscopy.

Keywords: Colonoscopy; Incomplete; Intubation rates; Japanese academic hospital; Risk factors; Inflammatory bowel disease

Core tip: In a Japanese academic hospital, we retrospectively evaluated the significant risk factors for incomplete colonoscopy. A total of 11812 consecutive Japanese people were enrolled. By age- and sex-adjusted analysis, the significant risk factors for incomplete colonoscopy were female sex, age ≥ 60 years old, a history of prior abdominal or pelvic surgery, inadequate bowel preparation, and inflammatory bowel disease (IBD). In Japanese men, by age-adjusted analysis, IBD was an independent risk factor for incomplete colonoscopy. Therefore, several characteristics in the Japanese population might predict technical difficulty with colonoscopy.