Development and validation of ‘BOWELPREP' score to assess adequacy of bowel preparation prior to colonoscopy

Aims To develop scoring system to assess adequacy of bowel preparation prior to colonoscopy.

Methods Adults (Age>18 years) undergoing diagnostic colonoscopy were prospectively included from July 2021- July 2022(Number=445). Demography, indication of colonoscopy, bowel movements after preparation, stool colour, time interval between preparation completion and procedure, preparation quantity, diet and water consumption in preceding 24 hours were noted. Boston bowel preparation score (BBPS) <6 was considered as poor bowel preparation. All patients received split dose bowel preparation regimens. Logistic regression was used to determine predictors of poor preparation. Risk scores were assigned using nomogram and Risk score (BOWELPREP score) was developed.

Results Poor bowel preparation was noted in 49 (11%) cases. On multivariate logistic regression analysis ([Table 1]), number of bowel movements, stool colour & form, interval between preparation and colonoscopy were significant factors associated with poor bowel preparation. Risk scores were assigned to three predictors using nomogram ([Table 1]). The nomogram performed well in terms of discrimination with area under ROC curve 0.859, 95% CI: 0.799–0.918, p<0.001. The cut off was 14.85 with 83.7 % sensitivity, 83.8 % specificity, 38.97% positive predictive value, 97.65% negative predictive value and diagnostic accuracy of 83.8% to determine inadequate bowel preparation.

Conclusions In this prospective study we identified several clinical risk factors associated with inadequate bowel preparation and developed BOWELPREP score a simple, clinical, accurate validated model to predict adequacy of bowel preparation prior to colonoscopy

Table 1  Showing results of multivariate logistic regression analysis and risk scores assigned to each variable using nomogram.

Publikationsverlauf

Artikel online veröffentlicht:
14. April 2023