# Comparison of Bowel Preparation Quality for Colonoscopy Between Inpatients and Outpatients: A Single-Center Prospective Observational Study in Lebanon

## TL;DR

The study found that inpatient status does not affect colonoscopy bowel preparation quality, with smoking and preparation regimen being more important factors.

## Contribution

This is the first study in Lebanon to investigate bowel preparation quality differences between inpatients and outpatients.

## Key findings

- Inpatient and outpatient bowel preparation quality was not significantly different.
- Smoking significantly reduced odds of good bowel preparation.
- Split-dose regimens improved bowel cleansing compared to single-dose regimens.

## Abstract

Background: Inadequate bowel cleansing is a common challenge among patients undergoing colonoscopy. However, no prior study has specifically investigated whether admission status itself contributes to suboptimal preparation in the Lebanese population.

Objectives: To compare the adequacy of bowel preparation between inpatients and outpatients and to identify independent predictors of poor bowel cleansing.

Methods: This prospective, single-center observational study was conducted at a tertiary care hospital and included colonoscopies performed on both inpatients and outpatients. A total of 217 procedures were analyzed (109 outpatients and 108 inpatients). Bowel preparation quality was evaluated using the Boston Bowel Preparation Scale (BBPS). Univariate and multivariate logistic regression analyses were used to identify factors associated with inadequate bowel preparation.

Results: No statistically significant difference in bowel preparation adequacy was found between inpatients and outpatients. In the overall cohort, two independent predictors of bowel preparation quality were identified. Smoking was significantly associated with inadequate cleansing, with smokers having 62.4% lower odds of achieving good preparation compared to non-smokers (OR = 0.376; p = 0.002). Conversely, the use of a split-dose regimen significantly improved bowel cleansing, increasing the odds of adequate preparation by nearly five times compared to single-dose regimens (OR = 4.96; p = 0.001).

Conclusions: Inpatient status was not associated with inferior bowel preparation compared to outpatient status. Smoking and the type of bowel preparation regimen (split- vs. single-dose) were the most significant predictors of bowel cleansing quality.