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

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• 作者：Anupam Singh ; MD ; Christopher Marshall ; MD ; Biswashree Chaudhuri ; MD ; Chidimma Okoli ; MD ; Anne Foley ; BA ; Sharina D. Person ; PhD ; Kanishka Bhattacharya ; MD ; David R. Cave ; MD ; PhD
• 关键词：OGIB ; obscure GI bleeding ; OOGIB ; overt obscure GI bleeding ; VCE ; video capsule endoscopy
• 刊名：Gastrointestinal Endoscopy
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：77
• 期：5
• 页码：761-766
• 全文大小：742 K

文摘

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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 the <3-day group compared with 27.8 % of the >3-day group (P = .046) versus 25.8 % of the outpatients. Therapeutic intervention was performed in 18.9 % of the <3-day group versus 7.4 % of the >3-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 the <3-day cohort, at 6.1 versus 10.3 in the >3-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.