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Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule.

Abstract：

BACKGROUND:Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue. OBJECTIVE:To examine PDR variation with the MCR shift schedule. DESIGN:Retrospective cohort. SETTING:Outpatient tertiary-care center. PATIENTS:This study involved completed outpatient colonoscopies in 2008. Procedures were excluded for lack of withdrawal time stamps, indications other than average-risk screening, inadequate bowel preparation, fellow participation, or performance by endoscopists with a low number of endoscopies performed. INTERVENTION:None. MAIN OUTCOME MEASUREMENTS:PDR (colonoscopies with ≥1 polyp divided by total number of colonoscopies) by shift of day. RESULTS:We analyzed 3846 colonoscopies. PDR varied significantly by shift (P = .008) on univariate analysis; results for shifts 1 and 3 were similar (39.0% vs 38.7%, respectively) whereas shift 2 had the highest PDR (44.7%). Mean withdrawal times were stable (P = .92). PDR also varied significantly (P < .0001) by month of year on univariate analysis. On multivariate analysis, patient age (P < .0001), patient gender (P < .0001), endoscopist mean withdrawal time (P < .0001), month of year (P = .0002), endoscopist experience (P = .04), and shift of day (P = .048) significantly predicted PDR. LIMITATIONS:Retrospective study. CONCLUSION:MCR's 3-hour shift schedule does not show a decrease in PDR as the day progresses, as seen in other recent studies. Intervention trials at other institutions could determine whether alterations in shift length lead to PDR improvements.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Munson GW,Harewood GC,Francis DL

doi

10.1016/j.gie.2010.07.025

subject

Has Abstract

pub_date

2011-03-01 00:00:00

pages

467-75

issue

3

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(10)01895-X

journal_volume

73

pub_type

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