Delays in inpatient colonoscopy are commonly caused by inadequate bowel preparation and result in increased hospital length of stay (LOS) and healthcare costs. Low volume bowel preparation (LV-BP; sodium sulfate, potassium sulfate, and magnesium sulfate) has been shown to improve outpatient bowel preparation quality compared to standard high volume bowel preparations (HV-BP; polyethylene glycol). However, its efficacy in hospitalized patients has not been well-studied. We assessed the impact of LV-BP on time to colonoscopy, hospital LOS, and bowel preparation quality among inpatients.
We performed a propensity score matched (PSM) analysis of adult inpatients undergoing colonoscopy who received either LV- or HV-BP prior to colonoscopy at a quaternary academic medical center. Multivariate regression models with feature selection were developed to assess the association between LV-BP and study outcomes.
Among 1,807 inpatients included in the study, 293 and 1,514 patients received LV- and HV-BP, respectively. Among the PSM population, LV-BP was associated with shorter time to colonoscopy (β: -0.43 [95% CI: -0.56-(-0.30)] while having similar odds of adequate preparation (odds ratio: 1.02 [95% CI: 0.71-1.46]; P=0.92). LV-BP was also significantly associated with decreased hospital LOS among elderly patients (age ≥75 years), patients with chronic kidney disease, and patients that were hospitalized with gastrointestinal bleeding.
LV-BP is associated with decreased time to colonoscopy in hospitalized patients. Elderly inpatients, inpatients with chronic kidney disease, and inpatients with gastrointestinal bleeding may particularly benefit from LV-BP. Prospective studies are needed to further establish the role of LV-BP for inpatient colonoscopies.