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Gastrointest Endosc. 2013 May;77(5):761-6. doi: 10.1016/j.gie.2012.11.041. Epub 2013 Feb 1.

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

Author information

1
University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA.

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 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.

PMID:
23375526
DOI:
10.1016/j.gie.2012.11.041
[Indexed for MEDLINE]

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