EFFECTIVENESS OF DIFFERENT VOLUMES OF PEG PREPARATION FOR COLONOSCOPY IN THE ELDERLY: A RETROSPECTIVE ANALYSIS OF A PROSPECTIVE COHORT

Aims To assess the effectiveness of different volumes of polyethylene glycol (PEG) preparations for colonoscopy and other factors associated with cleansing success in the elderly.

Methods We retrospectively reviewed a prospective cohort of 1289 in- and outpatients performing colonoscopy, after an afternoon-only or afternoon-morning 1, 2 or 4L PEG-based preparation. The elderly population was defined by age≥65 years. The primary endpoints were the assessment of cleansing success (CS) and high-quality cleansing (HQC) of the right-colon.

Results All 575 patients aged≥65 years were included in the analysis.

Overall, 54.6% of patients were male, mean age was 72.8±5.9 and 94.3% of subjects were outpatients. Colonoscopy was completed with cecal intubation in 95.5% of cases, CS was achieved in 70.3% and HQC of the right-colon in 17.7% of patients.

When analysing the effectiveness of bowel cleansing by different PEG volumes, CS was achieved in 89.3%, 76.7% and 71.8% (p=0.024) for 1, 2 and 4L PEG, and HQC of the right colon in 36.9%, 9.4% and 17.0%(p<0.001) for 1L, 2L and 4L PEG respectively.

At multivariate analysis, afternoon-morning regimen (OR=2.43, 95%CI=1.34-4.38; p=0.003), CS at previous colonoscopy (OR=2.29, 95%CI=1.14-4.73; p=0.02), tolerability score (OR=1.29, 95%CI=1.16-1.44; p<0.001), low-fiber diet (OR=2.45, 95%CI=1.42-4.24; p=0.001) and colonoscopy within 5 hours after preparation (OR=2.67, 95%CI=1.28-5.56; p=0.008) were independently associated with CS.

Conclusions Achieving adequate bowel cleansing in the elderly is challenging and influenced by many external factors. In these patients, 1L PEG is associated with higher rates of CS and HQC of the right-colon compared to higher volume PEG preparations.

Publication History

Article published online:
14 April 2022