Modifiable factors including weekend consultations are major contributors to inpatient colonoscopy delays

Table 1 Factors driving delay of colonoscopy procedures, n (%)

Factors associated with inpatient colonoscopy delay (may be more than one factor per delay)	Delayed colonoscopy procedures (n = 302)
Clinical delays
Change in clinical recommendations	160 (53.0)
Inadequate bowel preparation	55 (18.2)
Pending medical optimization	48 (15.9)
Planned extended bowel preparation	27 (8.9)
Esophagogastroduodenoscopy prior to colonoscopy	20 (6.6)
Holding anticoagulation/antiplatelet therapy for a specified time	8 (2.6)
Pending INR/platelets optimization	9 (3.0)
Logistical delays
Weekend scheduling limitations	53 (17.5)
Weekday scheduling limitations and/or failure to initiate a clear liquid diet	66 (21.9)

INR: International normalised ratio.

Table 2 General description by delay status, n (%)

Factor	Delayed procedures (n = 302)	Non-delayed procedures (n = 469)	P value
Age, mean (SD)	60.2 (17.6)	59.5 (18.2)	0.586
Sex			0.524
Male	155 (51.3)	253 (53.9)
Female	147 (48.7)	216 (46.1)
Ethnicity			0.422
Not Hispanic or Latino	261 (86.4)	389 (82.9)
Hispanic or Latino	30 (9.9)	60 (12.8)
Declined	11 (3.6)	20 (4.3)
LOS, median calendar days (interquartile range) (range)	8 (5-14) (2, 134)	4 (3-8) (1, 169)	< 0.001
Day of the week consult note signed			0.001
Monday	57 (18.9)	65 (13.9)
Tuesday	55 (18.2)	77 (16.4)
Wednesday	43 (14.2)	75 (16.0)
Thursday	36 (11.9)	105 (22.4)
Friday	30 (9.9)	60 (12.8)
Saturday	36 (11.9)	46 (9.8)
Sunday	45 (14.9)	41 (8.7)
Admission indication			< 0.001
No GI	38 (12.6)	27 (5.8)
Only GI	99 (32.8)	234 (49.9)
Both GI and other	165 (54.6)	208 (44.3)
GI bleed	85 (28.1)	194 (41.4)	< 0.001
Anemia	114 (37.7)	158 (33.7)	0.283
Other GI indication	145 (48.0)	214 (45.6)	0.566
Primary/secondary indications			< 0.001
No GI indications	38 (12.6)	27 (5.8)
GI Primary	201 (66.6)	396 (84.4)
Non-GI primary and GI secondary	63 (20.9)	46 (9.8)

LOS: Length of stay; GI: Gastrointestinal.

Table 3 Influential factors for time to procedure among all procedures

Factor	Mean time to procedure, days (95%CI)	P value
Age
< 50	2.7 (2.2-3.1)	Ref
50-75	2.3 (1.9-2.7)	0.048
> 75	2.3 (1.9-2.7)	0.1
Sex
Male	2.2 (1.9-2.6)	Ref
Female	2.6 (2.2-3.0)	0.033
Ethnicity
Not Hispanic or Latino	2.7 (2.4-2.9)	Ref
Hispanic or Latino	2.6 (2.1-3.1)	0.79
Declined	2.0 (1.3-2.8)	0.104
Day of week
Weekday consultation (Monday-Friday)	2.1 (1.8-2.5)	Ref
Weekend consultation (Saturday-Sunday)	2.7 (2.3-3.2)	0.001
Admission indication
Only GI	1.7 (1.4-2.0)	Ref
No GI	3.3 (2.6-4.1)	< 0.001
Both GI and non-GI (GI primary)	2.1 (1.7-2.4)	0.038
Both GI and non-GI (GI secondary)	2.7 (2.2-3.3)	< 0.001
On admission
No GI bleed	2.6 (2.2-3.0)	Ref
GI bleed	2.2 (1.9-2.7)	0.085

Ref: Reference; GI: Gastrointestinal.

Table 4 Factors influencing length of stay among all procedures

Factor	Mean LOS, days (95%CI)	P value
Age
< 50	12.5 (10.6-14.7)	Ref
50-75	11.2 (9.6-13.0)	0.135
> 75	10.2 (8.5-12.2)	0.02
Sex
Male	11.6 (10.1-13.4)	Ref
Female	10.9 (9.3-12.7)	0.283
Ethnicity
Not Hispanic or Latino	11.5 (10.4-12.7)	Ref
Hispanic or Latino	11.2 (9.3-13.4)	0.762
Declined	11.1 (8.2-15.1)	0.833
Day of the week
Weekday consultation (Monday-Friday)	11.5 (10.1-13.2)	Ref
Weekend consultation (Saturday-Sunday)	11.0 (9.2-13.0)	0.477
Admission Indication
No GI	5.8 (5.0-6.7)	Ref
Only GI	21.1 (16.3-27.2)	< 0.001
Both GI and non-GI (GI primary)	8.1 (7.0-9.3)	< 0.001
Both GI and non-GI (GI secondary)	16.2 (13.4-19.6)	< 0.001
On admission
No GI bleed	12.4 (10.9-14.2)	Ref
GI bleed	10.2 (8.5-12.2)	0.01
No other GI diagnosis1	9.8 (8.5-11.2)	Ref
Other GI diagnosis1	13.0 (10.9-15.4)	< 0.001
Procedure status
Non-delayed	9.5 (8.1-11.0)	Ref
Delayed	13.4 (11.5-15.6)	< 0.001

¹Gastrointestinal diagnosis that is not anemia or gastrointestinal bleed.

Ref: Reference; LOS: Length of stay; GI: Gastrointestinal.

Table 5 Factors influencing length of stay among delayed procedures

Factor	Mean LOS, days (95%Cl)	P value
Age
< 50	32.8 (18.4-58.5)	Ref
50-75	33.5 (19.4-58.2)	0.828
> 75	28.8 (16.6-49.9)	0.297
Sex
Male	31.1 (18.0-53.8)	Ref
Female	32.2 (18.4-56.2)	0.713
Ethnicity
Not Hispanic or Latino	32.0 (19.0-53.9)	Ref
Hispanic or Latino	40.3 (22.7-71.6)	0.111
Declined	24.5 (12.2-49.3)	0.269
Admission indication
No GI	57.7 (31.3-106.3)	Ref
Only GI	19.7 (11.4-34.2)	< 0.001
Both GI and non-GI (GI primary)	25.3 (14.6-43.8)	0.019
Both GI and non-GI (GI secondary)	34.7 (19.6-61.7)	< 0.001
On admission
No GI bleed	34.8 (20.5-59.1)	Ref
GI bleed	28.7 (16.1-51.4)	0.079
No other GI diagnosis1	28.5 (16.8-48.4)	Ref
Other GI diagnosis1	35.1 (19.6-62.8)	0.059
Planning extended bowel preparation	33.6 (18.1-62.4)	Ref
No delay	29.8 (17.8-49.7)	0.454
Holding anticoagulation/antiplatelets	38.6 (18.8-79.3)	Ref
No delay	25.9 (16.3-41.3)	0.141
Inadequate bowel preparation	32.7 (18.1-59.0)	Ref
No delay	30.7 (18.2-51.8)	0.609
Pending medical optimization delay	36.0 (19.8-65.5)	Ref
No delay	27.8 (16.6-46.5)	0.037
Change in clinical recommendations delay	43.3 (24.0-78.1)	Ref
No delay	23.1 (13.7-38.9)	< 0.001
EGD prior to colonoscopy delay	26.7 (14.4-49.6)	Ref
No delay	37.5 (22.0-63.8)	0.077
Pending INR/platelets optimization delay	46.6 (23.3-93.3)	Ref
No delay	21.5 (13.3-34.6)	0.001
Required subsequent colonoscopy	47.2 (24.8-89.9)	Ref
No subsequent colonoscopy	21.2 (12.5-36.0)	< 0.001
Weekend scheduling	32.8 (18.6-58.1)	Ref
No delay	30.5 (17.7-52.5)	0.519
Weekday scheduling/failure to initiate clear liquid diet	33.2 (18.2-60.6)	Ref
No delay	30.2 (18.2-50.2)	0.43

¹Gastrointestinal diagnosis that is not anemia or gastrointestinal bleed.

Ref: Reference; LOS: Length of stay; GI: Gastrointestinal; INR: International normalised ratio; EGD: Esophagogastroduodenoscopy.