İleri yaş ile kolonoskopi öncesi yetersiz kolon temizliği arasındaki ilişki: 2350 hastalık Boston Barsak Hazırlığı Skalası temelli retrospektif analiz

Öz

Giriş ve Amaç: Kolonoskopi başarısı, işlem öncesi kolon temizliğinin kalitesiyle yakından ilişkilidir. Yetersiz kolon temizliği mukozal görünürlüğü azaltarak tanısal doğruluğu olumsuz etkileyebilir. Bu çalışmada, başta ileri yaş olmak üzere klinik değişkenlerin Boston Barsak Hazırlığı Skalası ile değerlendirilen kolon temizliği kalitesiyle ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Bu tek merkezli, retrospektif çalışmaya 01.01.2025–30.06.2025 tarihleri arasında kolonoskopi yapılan erişkin hastalar dahil edildi. Kolon temizliği toplam Boston Barsak Hazırlığı Skalası skoru ile değerlendirildi. Boston Barsak Hazırlığı Skalası < 6 yetersiz kolon temizliği, Boston Barsak Hazırlığı Skalası ≥ 6 yeterli kolon temizliği olarak tanımlandı. Yaş, cinsiyet, vücut kitle indeksi, diyabetes mellitus varlığı ve Amerikan Anesteziyologlar Derneği Fiziksel Durum Sınıflaması > 1 değişkenleri değerlendirildi. Gruplar karşılaştırıldı; işlem karakteristiği eğrisi, korelasyon ve ikili lojistik regresyon analizleri yapıldı. Bulgular: Çalışmaya 2350 hasta dahil edildi. Hastaların 224’ünde (%9,5) yetersiz kolon temizliği saptandı. Yetersiz kolon temizliği grubunda yaş medyanı daha yüksekti (64 yıl vs. 59 yıl; p < 0,001). Diyabetes mellitus ve Amerikan Anesteziyologlar Derneği Fiziksel Durum Sınıflaması > 1 oranları da bu grupta anlamlı olarak daha fazlaydı. Yaş ile Boston Barsak Hazırlığı Skalası skoru arasında negatif korelasyon saptandı (r = -0,210; p < 0,001). İşlem karakteristiği eğrisi analizinde yaşın yetersiz kolon temizliğini ayırt etme performansı sınırlıydı (Eğri altında kalan alan: 0,606; p < 0,001). Çok değişkenli analizde ileri yaş, diyabetes mellitus varlığı ve Amerikan Anesteziyologlar Derneği Fiziksel Durum Sınıflaması > 1 yeterli kolon temizliği olasılığında azalma ile bağımsız olarak ilişkiliydi. Sonuç: İleri yaş, diyabetes mellitus varlığı ve artmış sistemik hastalık yükü, kolonoskopi öncesi yetersiz kolon temizliği ile ilişkili bulunmuştur. Bu değişkenler, riskli hastaların işlem öncesi belirlenmesinde pratik göstergeler olarak kullanılabilir.

Anahtar Kelimeler

• Kolonoskopi
• Boston Barsak Hazırlığı Skalası
• ileri yaş
• diyabetes mellitus

Association of advanced age with inadequate bowel preparation before colonoscopy: A retrospective analysis of 2,350 patients using the Boston Bowel Preparation Scale

Öz

Background and Aims: The quality of bowel preparation is a major determinant of colonoscopy success. Inadequate bowel cleansing may reduce mucosal visibility and compromise diagnostic accuracy. This study aimed to evaluate the association between clinical variables, particularly advanced age, and bowel preparation quality assessed using the Boston Bowel Preparation Scale. Materials and Methods: This single-center retrospective study included adult patients who underwent colonoscopy between January 1, 2025, and June 30, 2025. Bowel preparation quality was evaluated using the total Boston Bowel Preparation Scale score. A Boston Bowel Preparation Scale score < 6 was classified as inadequate bowel preparation, whereas a score ≥ 6 was considered adequate. Age, sex, body mass index, diabetes mellitus, and American Society of Anesthesiologists Physical Status Classification System > 1 were evaluated. Group comparisons, receiver operating characteristic analysis, correlation analysis, and binary logistic regression analyses were performed. Results: A total of 2,350 patients were included. Inadequate bowel preparation was identified in 224 patients (9.5%). The median age was higher in the inadequate bowel preparation group than in the adequate preparation group (64 vs. 59 years; p < 0.001). Diabetes mellitus and American Society of Anesthesiologists Physical Status Classification System > 1 were also more frequent among patients with inadequate bowel preparation. Age was negatively correlated with the Boston Bowel Preparation Scale score (r = -0.210; p < 0.001). In receiver operating characteristic analysis, age showed limited discriminatory performance for inadequate bowel preparation (Area Under the Curve: 0.606; p < 0.001). In multivariable analysis, advanced age, diabetes mellitus, and American Society of Anesthesiologists Physical Status Classification System > 1 were independently associated with a lower likelihood of adequate bowel preparation. Conclusion: Advanced age, diabetes mellitus, and increased systemic disease burden were associated with inadequate bowel preparation before colonoscopy. These variables may serve as practical indicators for identifying patients at increased risk before the procedure.

Anahtar Kelimeler

• Colonoscopy
• Boston Bowel Preparation Scale
• advanced age
• diabetes mellitus

Kaynakça

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