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%
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