Wake Forest Baptist Medical Center, NC, United States
Steven Delaney, MD1, Ted G. Xiao, MD, MS2, Troy M. Pleasant, MD2, Jared Rejeski, MD2 1Wake Forest Baptist Medical Center, Winston-Salem, NC; 2Wake Forest Baptist Health, Winston-Salem, NC
Introduction: Management of polyps is an integral aspect of gastroenterology practice. Recent guidelines provide rationale and recommendations for screening, follow-up, and removal methods. These guidelines primarily focus on elective outpatient exams. We aimed to characterize findings, polyp therapy, and outcomes of patients undergoing inpatient colonoscopy for various indications to compare outcomes of those with and without polyps.
Methods: We conducted a retrospective review at a tertiary medical center of patients presenting for inpatient colonoscopy to compare patients with and without polyps on exam. The study spanned 52 months with 1041 colonoscopies assessed. We reviewed patient demographics, prior colonoscopy, current colonoscopy findings, follow-up colonoscopy findings, and recommended follow-up.
Results: A total of 298 of 1041 colonoscopies found a polyp or mass . Those with a polyp/mass tended to be older (65.7 vs 53 years), male (63.1% vs 47.4%, p< 0.003), and have better insurance coverage (p< 0.001). Race, PCP status, rate of prior colonoscopy/detected polyps, and prep quality did not differ between the groups. Of the patients with a mass or polyp, 73.2% underwent polypectomy or biopsy. Snare was the primary removal method at 47%. Patients who did not receive polyp removal or biopsy were more likely to have GI bleed on exam (31.2% vs. 11%, p< 0.001). Allowing for at least one-year follow-up, only 14.5% of patients without a polyp or mass returned for repeat colonoscopy compared to 21.8% of patients with a polyp/mass discovered. In the group with polyp/mass seen, those who didn't receive a biopsy were not statistically more likely to follow-up for repeat colonoscopy (27.5% vs 19.7%). Only 26.9% of patients without a polyp or mass seen on exam were given any follow-up recommendation in their colonoscopy report compared to 47% in the group with a mass or polyp.
Discussion: Looking at inpatient colonoscopy data, approximately 29% had a polyp or mass discovered on exam with the majority undergoing either polypectomy or biopsy. Unfortunately, follow-up recommendation rates in addition to rates of actual follow-up were low. Methods to improve follow-up along with documentation of follow-up recommendations would be valuable. Especially since many primary care providers will defer to a prior colonoscopy report for ordering repeat screening colonoscopies. Although these exams are done in the inpatient setting for a particular indication, they could still impact future screening intervals.
Disclosures: Steven Delaney indicated no relevant financial relationships. Ted Xiao indicated no relevant financial relationships. Troy Pleasant indicated no relevant financial relationships. Jared Rejeski indicated no relevant financial relationships.
Steven Delaney, MD1, Ted G. Xiao, MD, MS2, Troy M. Pleasant, MD2, Jared Rejeski, MD2. P1315 - Comparing Management and Follow-up of Inpatient Colonoscopies Depending on Presence of Colonic Neoplasia, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
