BARIUM ENEMAS IN THE FRAIL ELDERLY

PURPOSE: The objective of this investigation was to determine the frequency of and predictors for inadequate barium enemas in the frail elderly. PATIENTS AND METHODS: The medical and radiologic records of 171 elderly institutionalized patients (mean age = 85.3 years), who underwent barium enema examinations, were retrospectively reviewed. The study outcome of primary interest was the radiologist's report of the adequacy of examination as indicated in the written summary of the results of the barium enema procedure. RESULTS: Eighty-eight (51.5%) of the 171 studies were deemed inadequate, with poor bowel preparation a primary or contributing factor in 89.7% of the inadequate studies. Among a variety of demographic and clinical factors, only long-term laxative and/or cathartic use was associated with an inadequate study (odds ratio = 7.0; 95% confidence interval 2.7 to 18.0). CONCLUSION: These results demonstrate a very high frequency of inadequate barium enema examinations in the very old and suggest a need for improved methods of bowel preparation in this patient population, especially in those who are long-term users of laxatives and cathartics.