Endoscopy 2020; 52(S 01): S163-S164
DOI: 10.1055/s-0040-1704505
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1-LITER POLYETHILENE GLYCOL (1L-PEG) BOWEL PREPARATION VS. 4L- PEG FOR COLON CLEANSING AMONG INPATIENTS: A PROPENSITY SCORE MATCHING ANALYSIS FROM A LARGE MULTICENTER PROSPECTIVE COHORT

L Frazzoni
1   University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
,
C Spada
2   Fondazione Poliambulanza, Digestive Endoscopy Unit, Brescia, Italy
,
F Radaelli
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
,
A Mussetto
4   Santa Maria delle Croci Hospital, Gastroenterology Unit, Ravenna, Italy
,
C Fabbri
5   Gastroenterology Unit, Forlì-Cesena Hospitals, AUSL Romagna, Italy
,
L Laterza
1   University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
,
M Manno
6   Carpi Hospital, Digestive Endoscopy Unit, USL Modena, Italy
,
G Manes
7   ASST Rhodense, Rho and Garbagnate Milanese Hospital, Department of Gastroenterology, Milan, Italy
,
S Piccirelli
2   Fondazione Poliambulanza, Digestive Endoscopy Unit, Brescia, Italy
,
ML Marca
1   University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
,
G Aragona
8   Guglielmo da Saliceto Hospital, Gastroenterology Unit, Piacenza, Italy
,
S Cadoni
9   S. Barbara Hospital, Digestive Endoscopy Unit, Iglesias, Italy
,
F Bazzoli
1   University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
,
P Occhipinti
10   Ospedale Maggiore della Carità, Gastroenterology Unit, Novara, Italy
,
E Rondonotti
3   Valduce Hospital, Gastroenterology Unit, Como, Italy
,
C Hassan
11   Nuovo Regina Margherita Hospital, Digestive Endoscopy Unit, Roma, Italy
,
L Fuccio
1   University of Bologna, Department of Medical and Surgical Sciences, Bologna, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims The inpatient status is one of the strongest independent predictors for inadequate colon cleansing. The best strategy for bowel preparation among inpatients is yet unknown. Based on experts’ opinion, high-volume, 4L polyethilene glycol (PEG) solution should be the standard-of-care in this setting. We aimed to determine whether the novel 1L-PEG plus ascorbate prep is associated with increased colon cleansing among inpatients.

Methods Patients enrolled in a large Italian multicenter prospective observational study on bowel prep for inpatients (QIPS study) were considered for inclusion. We performed a propensity score matching analysis in order to adjust for age, gender, Charlson comorbidity index, and all of the significant risk factors for inadequate colon cleansing reported in the QIPS study (i.e. days of hospitalization before colonoscopy, patient’s autonomy, constipation, diabetes, anti-psychotic drugs intake, day-before vs. split-dose/same-day regimen, and compliance to bowel prep) between PEG-1L and PEG-4L group. The primary outcome was the rate of adequate colon cleansing, as defined by Boston Bowel Preparation Scale ≥2 in any colon segment.

Results Among 1,524 patients who underwent colonoscopy, 717 took PEG-4L and 183 PEG-1L. Overall, adequate colon cleansing was found in 442 (61.7%) and 159 (86.9%) in PEG-4L and PEG-1L group, respectively (p=0.01). After propensity matching, we selected 183 pairs of patients with similar distribution of possible confounders. Adequate colon cleansing was significantly higher in the PEG-1L group than in the PEG-4L group (86.9% vs. 74.9%, p=0.01), with a number needed to prep (NNP) of 9, meaning that one adequate colon cleansing is gained every 9 hospitalized patients prepared with 1L-PEG, as compared with 4L-PEG.

Conclusions After correcting for possible confounders, we found a higher rate of adequate colon cleansing for colonoscopy with the 1L-PEG bowel prep vs. 4L-PEG among inpatients. A randomized controlled trial is urgently needed to confirm our findings.