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Your search keyword '"Caecal intubation rate"' showing total 2 results
Start Over Descriptor "Caecal intubation rate" Topic adenoma
2 results on '"Caecal intubation rate"'

1. Achieving high quality colonoscopy: using graphical representation to measure performance and reset standards.

Author

Rajasekhar, P. T., Rutter, M. D., Bramble, M. G., Wilson, D. W., East, J. E., Greenaway, J. R., Saunders, B. P., Lee, T. J. W., Barton, R., Hungin, A. P. S., and Rees, C. J.

Subjects
*COLONOSCOPY, *INTUBATION, *ADENOMA, *FENTANYL, *QUALITY assurance, *THERAPEUTICS
Abstract

Aim Completeness and thoroughness of colonoscopy are measured by the caecal intubation rate (CIR) and the adenoma detection rate (ADR). National standards are ≥ 90% and ≥ 10% respectively. Variability in CIR and ADR have been demonstrated but comparison between individuals and units is difficult. We aimed to assess the performance of colonoscopy in endoscopy units in the northeast of England. Method Data on colonoscopy performance and sedation use were collected over 3 months from 12 units. Colonoscopies performed by screening colonoscopists were included for the CIR only. Funnel plots with upper and lower 95% confidence limits for CIR and ADR were created. Results CIR was 92.5% ( n = 5720) and ADR 15.9% ( n = 4748). All units and 128 (99.2%) colonoscopists were above the lower limit for CIR. All units achieved the ADR standard with 10 above the upper limit. Ninety-nine (76.7%) colonoscopists were above 10%, 16 (12.4%) above the upper limit and 7 (5.4%) below the lower limit. Median medication doses were 2.2 mg midazolam, 29.4 mg pethidine and 83.3 μg fentanyl. In all, 15.1% of colonoscopies were unsedated. Complications were bleeding (0.10%) and perforation (0.02%). There was one death possibly related to bowel preparation. Conclusion Results indicate that colonoscopies are performed safely and to a high standard. Funnel plots can highlight variability and areas for improvement. Analyses of ADR presented graphically around the global mean suggest that the national standard should be reset at 15%. [ABSTRACT FROM AUTHOR]

Published
2012
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2. Quality of colonoscopy in an emerging country: A prospective, multicentre study in Russia

Author

Vladimir Krushelnitsky, Franco Radaelli, Mikhail Korolev, Alexander Subbotin, Leonid Domarev, Aleksander Pyrkh, Mikhail Knyazev, Cesare Hassan, Aleksey Korotkevich, Sergey V. Kashin, Dmitry Mtvralashvili, Viktor Veselov, Sergey Gabriel, Mikhail Bykov, Dmitry Zavyalov, Konstantin Glebov, Irina Kruglova, Mikhail Burdyukov, Evgeny Shitikov, Evgeny Fedorov, Mariya Antipova, Ekaterina Mayat, Lorenzo Ridola, Alexander Taran, Alessandro Repici, Mikhail Merzlyakov, Oleg R. Sannikov, and Andrey Kotovsky

Subjects
medicine.medical_specialty, Adenoma, Sedation, medicine.medical_treatment, adenoma detection rate, Colonoscopy, caecal intubation rate, colonoscopy, quality, screening, 03 medical and health sciences, 0302 clinical medicine, Medicine, Intubation, 030212 general & internal medicine, Interval cancer, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, Mean age, Original Articles, medicine.disease, Surgery, Oncology, 030211 gastroenterology & hepatology, medicine.symptom, Detection rate, business, Developed country
Abstract

The quality of colonoscopy has been related to a higher risk of interval cancer, and this issue has been addressed extensively in developed countries. The aim of our study was to explore the main quality indicators of colonoscopy in a large emerging country.Consecutive patients referred for colonoscopy in 14 centres were prospectively included between July and October 2014. Before colonoscopy, several clinical and demographic variables were collected. Main quality indicators (i.e. caecal intubation rate, (advanced) adenoma detection rate, rate of adequate cleansing and sedation) were collected. Data were analysed atA total of 8829 (males: 35%; mean age: 57 + 14 years) patients were included, with 11 centres enrolling at least 100 patients. Screening (including non-alarm symptoms) accounted for 59% (5188/8829) of the indications. Sedation and split preparation were used in 26% (2294/8829) and 25% (2187/8829) of the patients. Caecal intubation was achieved in 7616 patients (86%), and it was ≥85% in 8/11 (73%) centres. Adenoma detection rate was 18% (1550/8829), and it was higher than 20% in five (45%) centres, whilst it was lower than 10% in four (33%) centres. At multivariate analysis, age (OR: 1.020, 95% CI: 1.015-1.024), male sex (OR: 1.2, 95% CI: 1.1-1.3), alarm symptoms (OR: 1.8, 95% CI: 1.7-2), split preparation (OR: 1.4, 95% CI: 1.2-1.6), caecal intubation rate (OR: 1.6, 95% CI: 1.3-1.9) and withdrawal time measurement (OR: 1.2, 95% CI: 1.6-2.1) were predictors of a higher adenoma detection rate, while adequate preparation (OR: 3.4: 95% CI: 2.9-3.9) and sedation (OR: 1.3; 95% CI: 1.1-1.6) were the strongest predictors of caecal intubation rate.According to our study, there is a substantial intercentre variability in the main quality indicators. Overall, the caecal intubation rate appears to be acceptable in most centres, whilst the overall level of adenoma detection appears low, with less than half of the centres being higher than 20%. Educational and quality assurance programs, including higher rates of sedation and split regimen of preparation, may be necessary to increase the key quality indicators.

Published
2017

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