Quality Indicators of Colonoscopy: A Study of 150 Patients

Abstract

Background: Colonoscopy is the most effective method for detecting and preventing colorectal cancer (CRC). Its diagnostic
success is strongly tied to bowel preparation quality and performance metrics such as adenoma detection rate (ADR). Poor
preparation leads to missed lesions, prolonged procedures, and higher repeat-colonoscopy rates, making quality monitoring
essential.
Objectives: This study evaluated colonoscopy performance indicators specifically bowel-prep quality and ADR among
patients undergoing screening, surveillance, and diagnostic colonoscopies. It also assessed how patient comorbidities, lesion
distribution, and histopathology influenced detection outcomes.
Methods: A retrospective quality improvement (QI) review of 150 colonoscopies was performed at Mercy Fitzgerald Hospital
between January and April 2022. Data were extracted from endoscopy and pathology reports, including ASA classification, bowel
preparation quality, lesion characteristics, and recommended follow-up. Descriptive analysis was conducted using SPSS v27.
Results: Most patients were ASA II or III, with a mean age of 61 years. An exceptional ADR of 88% was observed, far surpassing
typical organizational benchmarks (25–30%). Tubular adenomas were the most common finding. Good bowel preparation
yielded the highest lesion-detection efficiency, while excellent prep improved visualization but did not significantly increase
polyp counts. Fair or poor prep was more frequent among patients with higher ASA classifications.
Conclusion: While ADR was exceptionally high, bowel prep quality especially among medically complex patients remains
an area for targeted improvement. Enhanced preparation strategies, individualized regimens, and patient education could
improve visualization, reduce missed lesions, and align performance with national guidelines.