Title

Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study

UMMS Affiliation

Department of Medicine, Division of Gastroenterology; Department of Quantitative Health Sciences

Date

5-1-2013

Document Type

Article

Medical Subject Headings

Aged; Aged, 80 and over; Ambulatory Care; Capsule Endoscopy; Female; Gastrointestinal Hemorrhage; Hospitalization; Humans; Length of Stay; Male; Middle Aged; Retrospective Studies; Time Factors; Vascular Malformations

Disciplines

Digestive System Diseases | Gastroenterology

Abstract

BACKGROUND: Diagnostic yield of video capsule endoscopy (VCE) may be higher if it is performed closer to the time of overt obscure GI bleeding (OOGIB).

OBJECTIVE: To evaluate the diagnostic yield of VCE and rate of therapeutic intervention for OOGIB for inpatients and outpatients with respect to timing of the intervention.

DESIGN: Retrospective cohort study.

SETTING: Tertiary academic center.

PATIENTS: Patients who had VCE for OOGIB between August 2008 and August 2010.

INTERVENTIONS: VCE for inpatients versus outpatients.

MAIN OUTCOME MEASURES: Diagnostic yield and rate of therapeutic intervention for inpatients versus outpatients.

RESULTS: One hundred forty-four inpatients (65 women) and 116 outpatients (49 women) were included. Diagnostic yield was 65.9% for inpatients versus 53.4% for outpatients (P = .054). Inpatients were divided into those who had VCE within 3 days (<3 >days; n = 90) of admission versus after 3 days (>3 days; n = 54). Active bleeding and/or an angioectasia was found in 44.4% of the3-day group (P = .046) versus 25.8% of the outpatients. Therapeutic intervention was performed in 18.9% of the3-day group (P = .046) versus 10.3% of outpatients. Diagnostic yield and therapeutic intervention rate between the >3-day group and outpatients were not significantly different. Length of stay (days) was less in the3-day cohort (P < .0001).

LIMITATIONS: Long-term outcomes were not studied. This was a retrospective study.

CONCLUSIONS: Early deployment of VCE within 3 days of admission results in a higher diagnostic yield and therapeutic intervention rate and an associated reduction of length of stay.

Comments

Citation: Singh A, Marshall C, Chaudhuri B, Okoli C, Foley A, Person SD, Bhattacharya K, Cave DR. Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study. Gastrointest Endosc. 2013 May;77(5):761-6. doi: 10.1016/j.gie.2012.11.041. Link to article on publisher's website

Related Resources

Link to article in PubMed

Keywords

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