Barium enemas in the frail elderly

Gurwitz, Jerry H.; Noonan, James P.; Sánchez, María José; Prather, William

doi:10.1016/0002-9343(92)90013-2

Cited by 25 publications

(14 citation statements)

References 17 publications

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“…This percentage is in accordance with those reported in previous studies; e.g. Tinetti et al [5] (31%) and Gurwitz et al [6] (51.5%).…”

Section: Discussionsupporting

confidence: 83%

“…0.001). Such significant correlations with the patient's functional status have not been shown in previous studies [5,6]. The presence of dementia was shown to contribute to the likelihood of an inadequate BE examination in the study group of Tinetti et al [5].…”

Section: Discussionmentioning

confidence: 43%

“…Bowel preparation was performed as recommended [4][5][6] and included the following steps: (1) 3 days before the examination, the patient began a low-residue diet; (2) on the day preceding the study, the diet was changed to clear liquids and the patient received magnesium citrate or laxatives; (3) the patient received rinsing enemas on the evening before the examination and again on the morning of the study, and (4) the patient took nothing by mouth from late evening prior to the examination until the examination was completed.…”

Section: Methodsmentioning

confidence: 99%

“…Frail elderly patients may have trouble with any, or all, of these requirements [4][5][6]. Two previous reports have shown a very high rate of unsuccessful BE examinations among these patients [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Barium Enema in Frail Elderly Patients

Segal

Khahil²,

Leibovitz³

et al. 2000

Gerontology

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Background: Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients. Objective: The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients. Methods: Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed. Results: One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient’s functional status (p < 0.001) and the presence of dementia (p < 0.001). Conclusions: The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly.

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“…This percentage is in accordance with those reported in previous studies; e.g. Tinetti et al [5] (31%) and Gurwitz et al [6] (51.5%).…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 43%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Barium Enema in Frail Elderly Patients

Segal

Khahil²,

Leibovitz³

et al. 2000

Gerontology

View full text Add to dashboard Cite

show abstract

“…Increasing pressure on hospital beds effectively precludes inpatient preparation except for the most immobile or infirm patients. Added costs and knowledge that preparation supervised in hospital may be less satisfactory than that done at home1 2 also counsel against inpatient preparation. However, the adverse effects of preparation at home may have hidden costs, and the likelihood of adverse effects may be particularly high in elderly people.…”

mentioning

confidence: 99%