Predictors of inadequate bowel preparation in older patients undergoing colonoscopy: A systematic review and meta-analysis

Zhang Y 1 , Wang L 2 , Wu W 3 , Zhang S 1 , Zhang M 1 , She W 4 Show all authors , Cheng Q 1 , Chen N 1 , Fan P 1 , Du Y 1 , Song H 5 , Hu X 6 , Zhang J 5 , Ding C 7

Affiliations 

  • 1 School of Medical and Health Engineering, Changzhou University, Changzhou 213000, Jiangsu, China
  • 2 Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor 43400, Malaysia
  • 3 School of Nursing, Dalian Medical University, Dalian 116044, Liaoning, China
  • 4 Department of Nursing, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
  • 5 Department of Nursing, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China
  • 6 Department of Cardiology, The First People's Hospital of Kunshan, Suzhou 215300, Jiangsu, China
  • 7 Nursing Teaching and Research Department, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou 213000, Jiangsu, China. Electronic address: dingcaiyanczey@163.com
Int J Nurs Stud, 2024 Jan;149:104631.
PMID: 37963423 DOI: 10.1016/j.ijnurstu.2023.104631

Abstract

BACKGROUND: Factors that predict the quality of bowel preparation in older adults are unclear, and current guidelines do not provide specific recommendations.

OBJECTIVE: This meta-analysis aimed to identify risk factors for inadequate bowel preparation in older patients.

METHODS: PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP databases were searched from their inception to February 2023. Cohort and cross-sectional studies exploring the risk factors for inadequate bowel preparation were included in this systematic review. Odds ratio (OR) values from individual studies were pooled using fixed-effects and random-effects models. In addition, a sensitivity analysis and assessment of publication bias were performed.

RESULTS: This meta-analysis included six studies (n = 1553) on previous abdominal surgery, six studies (n = 1494) on constipation, seven studies (n = 1505) on diabetes, eight studies (n = 2093) on non-compliance with the diet regimen, seven studies (n = 1350) on incomplete intake of laxative, and nine studies (n = 2163) on inadequate exercise during preparation. The pooled analysis showed that history of abdominal surgery (OR = 2.72; 95 % confidence interval, CI: 2.07 to 3.56), constipation (OR = 3.56, 95 % CI: 2.41 to 5.25), diabetes (OR = 2.54, 95 % CI: 1.81 to 3.57), non-compliance with the diet regimen (OR = 2.51, 95 % CI: 1.96 to 3.21), incomplete intake of laxative (OR = 2.43, 95 % CI: 1.60 to 3.67), and inadequate exercise during preparation (OR = 3.13, 95 % CI: 2.39 to 4.11) were independent risk factors for inadequate bowel preparation in older patients undergoing colonoscopy.

CONCLUSIONS: Three comorbid factors and three behavioral factors were significantly associated with inadequate bowel preparation in older adults. This meta-analysis provides valuable information for developing predictive models of poor bowel preparation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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