Shingina A, Ou G, Takach O, Svarta S, Kwok R, Tong J, Donaldson K, Lam E, Enns R. Identification of factors associated with sedation tolerance in 5000 patients undergoing outpatient colonoscopy: Canadian tertiary center experience. World J Gastrointest Endosc 2016; 8(20): 770-776 [PMID: 28042391 DOI: 10.4253/wjge.v8.i20.770]
Corresponding Author of This Article
Robert Enns, MD, Division of Gastroenterology, Saint Paul Hospital, 770-1190 Hornby Street, Vancouver V6Z 2K5, Canada. rob.enns@ubc.ca
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Dec 16, 2016; 8(20): 770-776 Published online Dec 16, 2016. doi: 10.4253/wjge.v8.i20.770
Identification of factors associated with sedation tolerance in 5000 patients undergoing outpatient colonoscopy: Canadian tertiary center experience
Alexandra Shingina, George Ou, Oliver Takach, Sigrid Svarta, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns
Alexandra Shingina, Department of Gastroenterology, Faculty of Medicine, University of Toronto, Toronto General Hospital, Ontario M5G 2C4, Canada
George Ou, Sigrid Svarta, Department of Gastroenterology, Faculty of Medicine, University of British Columbia, Vancouver V5Z 1M9, Canada
Oliver Takach, Ricky Kwok, Jessica Tong, Kieran Donaldson, Eric Lam, Robert Enns, Division of Gastroenterology, Saint Paul Hospital, Vancouver V6Z 2K5, Canada
Author contributions: Shingina A and Enns R designed the project; Shingina A and Svarta S designed ethics proposal; Shingina A, Ou G, Svarta S, Kwok R, Donaldson K collected the data; Takach O and Lam E analyzed the data; Shingina A, Ou G, Svarta S, Lam E and Enns R wrote the manuscript.
Institutional review board statement: This study was reviewed and approved by the University of British Columbia - Providence Health Care Research Institute.
Informed consent statement: The informed consent is not applicable since this study is a retrospective review. All clinical data collected was dissociated from patient identifiers using a combination of alphanumeric characters in accordance to ethics board’s requirements.
Conflict-of-interest statement: All authors of this paper have no relevant conflicts of interest to declare.
Data sharing statement: No data were created so no data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Robert Enns, MD, Division of Gastroenterology, Saint Paul Hospital, 770-1190 Hornby Street, Vancouver V6Z 2K5, Canada. rob.enns@ubc.ca
Telephone: +1-604-6886332
Received: April 20, 2016 Peer-review started: April 20, 2016 First decision: June 12, 2016 Revised: July 25, 2016 Accepted: September 6, 2016 Article in press: September 8, 2016 Published online: December 16, 2016 Processing time: 238 Days and 8.6 Hours
Core Tip
Core tip: This manuscript explores patient specific characteristics that are associated with increased sedation tolerance based on retrospective review of 5000 patients that underwent outpatient colonoscopies. Using a logistic regression analysis, we developed a predictive model that can identify patients requiring higher than usual sedation doses using pre-procedurally available patient parameters. The final prediction model that includes age, indication for the procedure, medication/substance use, previous surgeries yielded an area under the curve of 0.76 for Fentanyl ≥ 100 mcg and Midazolam ≥ 3 mg. This modelling could help optimize periprocedural planning and potentially identify patients who would benefit from alternative sedation methods, e.g., propofol.
