Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study
Department of Medicine, Division of Gastroenterology; Department of Quantitative Health Sciences
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
Digestive System Diseases | Gastroenterology
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.
DOI of Published Version
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
Singh, Anupam; Marshall, Christopher; Chaudhuri, Biswashree; Okoli, Chidimma; Foley, Anne; Person, Sharina D.; Bhattacharya, Kanishka; and Cave, David R., "Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study" (2013). University of Massachusetts Medical School Faculty Publications. 299.