Factors that predict incomplete colonoscopy: Thinner is not always better

OBJECTIVE: The aim of this study was to determine whether anatomic factors such as body mass index (BMI) impacts the success rate of cecal intubation during colonoscopy. METHODS: We retrospectively reviewed the cecal intubation rate of 2000 colo noscopies performed at our institution from March 1997 to March 1999. The a nalysis sample was composed of charts for all incomplete procedures and a s ample (23%) of complete examinations that were randomly selected. Data coll ected included age, gender, height, weight, bowel habits, abdominal surgery , psychiatric medication use, the presence of diverticular disease, amount of sedation administered, and location and reason for halting the examinati on. Patients were divided by BMI: thin (BMT less than or equal to 22.1), av erage weight (BMI >22.1-25.0), overweight (BMI = 25.1-29.9), and obese (BMI >30). RESULTS: Colonoscopies in women had a lower adjusted completion rate (94.8% ) than in men (98.2%) (p < 0.005). A low BMI in women was predictive of, an incomplete examination (p < 0.001). Factors that did not predict incomplet e examinations in women included age and previous hysterectomy. The small n umber of male patients with an incomplete examination (n = 16) precluded ac curate identification of any factors. CONCLUSIONS: Women with a low BMI (especially <22) were more likely to have an incomplete procedure. This finding may have implications for colorectal cancer screening in female patients. (Am J Gastroenterol 2000;95: 2784-278 7. (C) 2000 by Am. Coll. of Gastroenterology).