Cecal intubation rates: data from the New Hampshire Colonoscopy Registry

iGIE Pub Date : 2024-09-01 DOI:10.1016/j.igie.2024.07.003

Alexander Miller MD , Nima Kamalpour MD , Lynn F. Butterly MD , Joseph C. Anderson MD

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Abstract

Background and Aims

Women and older or thinner patients have lower colonoscopy cecal intubation rates. We used data from the New Hampshire Colonoscopy Registry (NHCR) to examine the association between these and other endoscopist factors and trends of colonoscopy cecal intubation rates.

Methods

Our sample included patients ≥40 years from the NHCR with an adequate bowel preparation. We examined colonoscopy completion rates over quartiles (2004-2011, 2012-2014, 2015-2017, and 2018-2021) as stratified by men versus women and body mass index (BMI). In addition to these factors, we also adjusted for age and year of examination. Other variables of interest were specialty of the endoscopist and adenoma detection rates (ADRs).

Results

Our sample included 143,095 individuals (52.5% women [n = 75,180]). Multivariable analysis showed that BMI <25 (odds ratio [OR], .87; 95% confidence interval [CI], .76-.99), obesity (BMI ≥30) (OR, .88; 95% CI, .77-.99), and older age (per year) (OR, .96; 95% CI, .96-.97) were associated with a decreased likelihood of having a complete colonoscopy. Men were more likely than women to have a higher completion rate (OR, 1.46; 95% CI, 1.30-1.63). Gastroenterology specialty (OR, 1.78; 95% CI, 1.56-2.03) and an ADR ≥25% (OR, 2.01; 95% CI, 1.79-2.26) were associated with an increased likelihood of cecal intubation. These endoscopist-related factors were also observed to be predictive of cecal intubation in a subset of thin (BMI <25) women. Men and obese patients (BMI ≥30) were more likely to have incomplete examinations halted in the right-sided versus left-sided colon.

Conclusions

Even after adjusting for endoscopist factors, our study demonstrated that older or female patients and those with a BMI <25 or ≥30 had lower colonoscopy completion rates. Our data also suggest that colonoscopies performed in thin women were more likely to be completed if they were performed by a gastroenterologist as opposed to a nongastroenterologist.

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盲肠插管率：来自新罕布什尔州结肠镜检查登记处的数据

背景和目的女性、年龄较大或较瘦的患者结肠镜检查盲肠插管率较低。我们利用新罕布什尔州结肠镜检查登记处（NHCR）的数据，研究了这些因素和其他内镜医师因素与结肠镜检查盲肠插管率趋势之间的关联。我们按照男性和女性以及体重指数（BMI）对四分位数（2004-2011 年、2012-2014 年、2015-2017 年和 2018-2021 年）的结肠镜检查完成率进行了研究。除这些因素外，我们还对年龄和检查年份进行了调整。其他值得关注的变量包括内镜医师的专业性和腺瘤检出率（ADR）。结果我们的样本包括 143095 人（52.5% 为女性 [n = 75180]）。多变量分析表明，BMI <25（几率比 [OR]，.87；95% 置信区间 [CI]，.76-.99）、肥胖（BMI ≥30）（OR，.88；95% CI，.77-.99）和年龄（每年）（OR，.96；95% CI，.96-.97）与接受完整结肠镜检查的可能性降低有关。男性结肠镜检查完成率高于女性（OR，1.46；95% CI，1.30-1.63）。消化内科专业（OR，1.78；95% CI，1.56-2.03）和 ADR ≥25%（OR，2.01；95% CI，1.79-2.26）与盲肠插管的可能性增加有关。据观察，这些与内镜医师相关的因素也可预测瘦弱（BMI <25）女性子集的盲肠插管。结论即使在调整了内镜医师因素后，我们的研究仍表明，年龄较大或女性患者以及体重指数为 25 或≥30 的患者结肠镜检查完成率较低。我们的数据还表明，如果由消化内科医生而非非消化内科医生为瘦弱女性进行结肠镜检查，则结肠镜检查的完成率更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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