Original articleClinical endoscopyTiming of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study
Section snippets
Methods
Our center is a large referral facility for central and western Massachusetts. Five hundred and seven VCEs were performed over a 2-year period from August 2008 to August 2010. Two hundred sixty VCEs were done to evaluate OOGIB and were included in the study. Specifically, we excluded patients with occult OGIB or iron deficiency anemia from the evaluation. We had a large cohort of patients with OOGIB for both the inpatient (n = 144) and outpatient (n = 116) populations, which is a much larger
Results
The study design, including distribution of the patients, is showed in Figure 1, and patient demographics are presented in Table 1.
A positive result was defined as active bleeding, angioectasia, red spot, tumor, ulcer, or bleeding outside of the small intestine (stomach or colon). The overall yield of VCE was 65.9% (95 of 144) for the inpatient population versus 53.4% (62 of 116) for the outpatient population (P = .054). Red spots were included in the list of positive findings but were not
Discussion
In this retrospective analysis of the use of VCE performed for OOGIB in both inpatients and outpatients, we demonstrated that the early deployment of VCE results in a higher diagnostic yield and increased rate of therapeutic intervention. In turn, early deployment was associated with a significant reduction in length of stay, possibly associated with the increased intervention rate and reduction of the numbers of other procedures.
Statistically, the overall diagnostic yield of VCE was not
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DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: S D Person was partially supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers UL1RR031982 and UL1TR000161. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health. Otherwise this was an investigator-initiated study with no external funding. K Bhattacharya: research consultant in deep enteroscopy for Olympus Corp. D R Cave: research support consultant in video capsule endoscopy for Olympus Corp.; research support for Capsovision. All other authors disclosed no financial relationships relevant to this publication.