S383 Clinical Outcomes of Sodium Sulfate Tablets vs PEG-Based Solutions for Inpatient Colonoscopy Preparation: A Propensity-Matched Analysis

Introduction: Bowel preparation in hospitalized patients is frequently inadequate due to limited mobility, nausea, and comorbid conditions. Sodium sulfate tablets (Sutab) offer a low-volume alternative that may be better tolerated than traditional polyethylene glycol (PEG)-based solutions such as GoLYTELY and MoviPrep. This study compared procedural success and clinical outcomes of inpatients receiving Sutab versus GoLYTELY or MoviPrep prior to colonoscopy. Methods: We conducted a retrospective cohort study using the TriNetX health research network across 67 U.S. healthcare organizations. Adult in patients undergoing colonoscopy who received Sutab, GoLYTELY, or MoviPrep were identified. Propensity score matching was performed to balance demographics and comorbidities. The primary outcomes were colonoscopy completion and poor bowel preparation. Secondary outcomes included acute kidney injury (AKI), blood transfusion, aspiration pneumonia, mortality, and CTA abdomen utilization. Sutab was the only small volume preparation available for data analysis. GoLYTELY and Moviprep were the main preparations used in hospital settings according to TRINETX data. Results: After matching, 25,919 Sutab-GoLYTELY pairs and 11,922 Sutab-Moviprep pairs were analyzed. Compared to GoLYTELY, Sutab was associated with higher colonoscopy completion rates (35.6% vs 26.6%, P < 0.001), and lower rates of AKI (2.7% vs 7.0%), transfusion (0.6% vs 2.9%), aspiration pneumonia (0.3% vs 0.8%), and death (0.9% vs 3.4%) (all P < 0.001). Poor preparation rates were low in both groups (0.3% vs 0.4%, P = 0.025). Compared to MoviPrep, Sutab again showed superior colonoscopy completion (36.8% vs 23.5%, P < 0.001), with lower rates of AKI (3.7% vs 17.3%), transfusion (0.7% vs 10.1%), aspiration pneumonia (0.3% vs 2.4%), and death (1.2% vs 6.3%) (all P < 0.001). Poor prep rates were also reduced with Sutab (0.3% vs 0.8%, P < 0.001). Conclusion: Among hospitalized patients, Sutab demonstrated significantly improved procedural success and reduced adverse clinical outcomes compared to both GoLYTELY and MoviPrep. These findings suggest that Sutab may offer a more effective and safer bowel preparation strategy in inpatient settings. Hospitals should consider including Sutab in formularies to enhance colonoscopy readiness and minimize complications in this vulnerable population.