Braunstein et al developed a clinical prediction rule for identifying a patient likely to have a difficult sedation during colonoscopy.. The authors are from Columbia University in New York City.
SCOPE = Stratifying Clinical Outcome Prior to Endoscopy
Patient selection: sedation for colonoscopy, age 18 to 69 years (adult). The risk of difficult sedation in patients >= 70 years of age was very low.
Primary Endopoint: difficult sedation or high sedation requirement
Parameters:
(1) age of the patient in years
(2) indication for colonoscopy
(3) gender
(4) body mass index in kg per square meter
(5) tobacco use
(6) benzodiazepine use
(7) opioid use
(8) other psychoactive medication use (antidepressants, antipsychotics, etc)
|
Parameter |
Finding |
Points |
|---|---|---|
|
age of the patient |
18 to 29 years |
10 |
|
|
30 to 39 years |
10 |
|
|
40 to 49 years |
6 |
|
|
50 to 59 years |
2 |
|
|
60 to 69 |
0 |
|
indication |
diagnostic/other |
3 |
|
|
acute GI bleeding |
0 |
|
|
surveillance |
0 |
|
|
screening |
0 |
|
gender |
male |
0 |
|
|
female |
3 |
|
BMI |
< 25 |
2 |
|
|
>= 25 |
0 |
|
tobacco use |
no |
0 |
|
|
yes |
1 |
|
benzodiazepine use |
no |
0 |
|
|
yes |
6 |
|
opioid use |
no |
0 |
|
|
yes |
4 |
|
other psychoactive drug use |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
|
Score |
Class |
Difficult Sedation |
|---|---|---|
|
0 to 5 |
I |
8-9% |
|
6 to 10 |
II |
14-18% |
|
11 to 15 |
III |
18-22% |
|
16 to 19 |
IV |
29% |
|
20 to 30 |
V |
>= 54% |
Specialty: Anesthesiology, Pedatrics, Critical Care, Emergency Medicine, Surgery, general
ICD-10: ,
