To evaluate the association between Charlson Comorbidity Index (CCI), age-adjusted CCI (ACCI), and propofol requirement during advanced gastrointestinal endoscopy, and to develop a model for individualized sedation.
Approach:
Study Design: Retrospective cohort study including 1,555 adult patients undergoing advanced gastrointestinal endoscopy under BIS-guided TCI propofol sedation.
Data Collection: Demographic data, procedural characteristics, and comorbid conditions were extracted from electronic medical records.
Outcome Measures: Primary outcome was the lean body mass (LBM)-adjusted propofol infusion rate.
Statistical Analysis: Logistic regression analyses and sensitivity analyses were performed, with model discrimination evaluated using AUC.
Key Findings:
Older age, male sex, longer procedure duration, and higher CCI were independently associated with a lower probability of higher propofol requirement.
The model demonstrated good discrimination in both training (AUC 0.831) and validation cohorts (AUC 0.841).
Interpretation:
Older age, male sex, and higher comorbidity burden were found to be associated with lower relative propofol requirements during advanced gastrointestinal endoscopy.
Limitations:
External validation of the proposed model is required before clinical application.
The study was conducted at a single tertiary referral center, which may limit generalizability.
Conclusion:
The proposed model for individualized sedation management demonstrated acceptable discrimination.
