Analysis of Colonoscopy Quality in Clinical Practices of Korea: Cohort Study of Patients Referred to Tertiary Hospital after Colonoscopy Examinations

Chun, Chang Gyun; Kim, Hyun Gun; Jeon, Seong Ran; Ko, Bong Min; Lee, Byung Hoo; Kim, Jin Oh

Abstract

BACKGROUND/AIMS
Although the quality of colonoscopy is considered important to improve screening efficacy, there is little evidence and few statistical reports which properly reflects the colonoscopy quality of clinical practices in Korea. We aimed to investigate the quality indicators of colonoscopy performing in clinical practice.
METHODS
We analyzed the computerized photo-documentation files of patients who were transferred to tertiary academic hospital from private clinics or primary and secondary hospitals from January 2012 to October 2012. Quality indicators including cecal intubation rate, withdrawal time, bowel preparation status, colonoscopy report form were analyzed. Bowel preparation was assessed by 4 steps on the preparation scale (excellent, good, fair, poor).
RESULTS
A total of 198 patients (134 male, 64 female) were enrolled and analyzed. Cecal intubation rate was 91.4% (181/198) and photo-documentation of appendiceal orifice and ileocecal valve was achieved as 84.3% (167/198) and 71.7% (142/198), relatively. Overall, 83.3% of cases were adequate bowel preparation state (excellent 52%, good 31.3%). Withdrawal time could be estimated at 94.4% (187/198) of cases and mean withdrawal time of diagonostic colonoscopy (n=165) was 8.6 minutes. However, the rate of cases which withdrawal time was more than 6 minutes was 69.7% (115/165). Total of 30 institution's colonoscopy report forms were analyzed and among nearly half enrolled institutions (46.6%, 14/30) were just recording patient's information and colonoscopic diagnosis.
CONCLUSIONS
Considerable portion of colonoscopy examination in the primary clinical practice has been performed with low procedure quality. We thus need careful attention to maintain the quality of colonoscopy in daily practice routines.