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Efficacy and implications of a 48-h cutoff for video capsule endoscopy application in overt obscure gastrointestinal bleeding.

Kim SH, Keum B, Chun HJ, Yoo IK, Lee JM, Lee JS, Nam SJ, Choi HS, Kim ES, Seo YS, Jeen YT, Lee HS, Um SH, Kim CD - Endosc Int Open (2015)

Bottom Line: Therapeutic intervention was performed in 26.7 % and 9.4 % of patients in the < 48-h and > 48-h groups, respectively (P = 0.028).The mean lengths of hospital stay in the < 48-h and > 48-h groups were 5 days (95 % confidence interval [CI], 4.8 - 7.7) and 7 days (95 %CI, 6.9 - 10.1), respectively (P = 0.039).Therefore, VCE application with a 48-h cutoff could improve the outcome of patients with overt OGIB.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background and study aims: Early video capsule endoscopy (VCE) may provide a high diagnostic yield and improve clinical outcomes in patients with overt obscure gastrointestinal bleeding (OGIB); however, there is no practical recommendation for the ideal timing of VCE application in overt OGIB. Therefore, this study investigated the diagnostic yield and efficacy of VCE to assess overt OGIB with respect to the timing of application.

Patients and methods: We retrospectively enrolled patients who had undergone VCE for overt OGIB between April 2004 and February 2014 at a tertiary referral academic center. We included hemodynamically stable patients who underwent VCE for overt OGIB after negative bidirectional endoscopy. We analyzed the diagnostic yield of VCE, therapeutic intervention rate, and length of hospital stay.

Results: A total of 94 patients underwent VCE to assess overt OGIB. The diagnostic yields in the groups that underwent VCE < 48 h and > 48 h from the last overt OGIB were 66.7 % and 40.6 %, respectively (P = 0.019). Therapeutic intervention was performed in 26.7 % and 9.4 % of patients in the < 48-h and > 48-h groups, respectively (P = 0.028). The mean lengths of hospital stay in the < 48-h and > 48-h groups were 5 days (95 % confidence interval [CI], 4.8 - 7.7) and 7 days (95 %CI, 6.9 - 10.1), respectively (P = 0.039).

Conclusions: Performing VCE within 2 days from the last overt OGIB results in a higher diagnostic yield, higher therapeutic intervention rate, and shorter hospital stay. Therefore, VCE application with a 48-h cutoff could improve the outcome of patients with overt OGIB.

No MeSH data available.


Related in: MedlinePlus

 Diagnostic yield (%) for detecting active bleeding and/or angiodysplasia with respect to the time (days) after the last gastrointestinal bleeding.
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FI187-2:  Diagnostic yield (%) for detecting active bleeding and/or angiodysplasia with respect to the time (days) after the last gastrointestinal bleeding.

Mentions: We analyzed the rates of active bleeding and angiodysplasia lesions because of their clinical significance as indications for therapeutic intervention. Active bleeding was observed in 20 % (6/30) and 1.6 % (1/64) of the patients in the < 48-h and > 48-h groups, respectively. Angiodysplasia was observed in 13.3 % (4/30) and 12.5 % (8/64) of the patients in the < 48-h and > 48-h groups, respectively. The diagnostic yields for active bleeding and/or angiodysplasia were 33.3 % and 14.1 % in the < 48-h and > 48-h groups, respectively (P = 0.030). The diagnostic yields for detecting active bleeding and/or angiodysplasia decreased as time elapsed after the last overt OGIB (Fig. 2). The decrease in diagnostic yield with time in the > 48-h group was strengthened by the lower rates of active bleeding and/or angiodysplasia in the > 48-h group.


Efficacy and implications of a 48-h cutoff for video capsule endoscopy application in overt obscure gastrointestinal bleeding.

Kim SH, Keum B, Chun HJ, Yoo IK, Lee JM, Lee JS, Nam SJ, Choi HS, Kim ES, Seo YS, Jeen YT, Lee HS, Um SH, Kim CD - Endosc Int Open (2015)

 Diagnostic yield (%) for detecting active bleeding and/or angiodysplasia with respect to the time (days) after the last gastrointestinal bleeding.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554504&req=5

FI187-2:  Diagnostic yield (%) for detecting active bleeding and/or angiodysplasia with respect to the time (days) after the last gastrointestinal bleeding.
Mentions: We analyzed the rates of active bleeding and angiodysplasia lesions because of their clinical significance as indications for therapeutic intervention. Active bleeding was observed in 20 % (6/30) and 1.6 % (1/64) of the patients in the < 48-h and > 48-h groups, respectively. Angiodysplasia was observed in 13.3 % (4/30) and 12.5 % (8/64) of the patients in the < 48-h and > 48-h groups, respectively. The diagnostic yields for active bleeding and/or angiodysplasia were 33.3 % and 14.1 % in the < 48-h and > 48-h groups, respectively (P = 0.030). The diagnostic yields for detecting active bleeding and/or angiodysplasia decreased as time elapsed after the last overt OGIB (Fig. 2). The decrease in diagnostic yield with time in the > 48-h group was strengthened by the lower rates of active bleeding and/or angiodysplasia in the > 48-h group.

Bottom Line: Therapeutic intervention was performed in 26.7 % and 9.4 % of patients in the < 48-h and > 48-h groups, respectively (P = 0.028).The mean lengths of hospital stay in the < 48-h and > 48-h groups were 5 days (95 % confidence interval [CI], 4.8 - 7.7) and 7 days (95 %CI, 6.9 - 10.1), respectively (P = 0.039).Therefore, VCE application with a 48-h cutoff could improve the outcome of patients with overt OGIB.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.

ABSTRACT

Background and study aims: Early video capsule endoscopy (VCE) may provide a high diagnostic yield and improve clinical outcomes in patients with overt obscure gastrointestinal bleeding (OGIB); however, there is no practical recommendation for the ideal timing of VCE application in overt OGIB. Therefore, this study investigated the diagnostic yield and efficacy of VCE to assess overt OGIB with respect to the timing of application.

Patients and methods: We retrospectively enrolled patients who had undergone VCE for overt OGIB between April 2004 and February 2014 at a tertiary referral academic center. We included hemodynamically stable patients who underwent VCE for overt OGIB after negative bidirectional endoscopy. We analyzed the diagnostic yield of VCE, therapeutic intervention rate, and length of hospital stay.

Results: A total of 94 patients underwent VCE to assess overt OGIB. The diagnostic yields in the groups that underwent VCE < 48 h and > 48 h from the last overt OGIB were 66.7 % and 40.6 %, respectively (P = 0.019). Therapeutic intervention was performed in 26.7 % and 9.4 % of patients in the < 48-h and > 48-h groups, respectively (P = 0.028). The mean lengths of hospital stay in the < 48-h and > 48-h groups were 5 days (95 % confidence interval [CI], 4.8 - 7.7) and 7 days (95 %CI, 6.9 - 10.1), respectively (P = 0.039).

Conclusions: Performing VCE within 2 days from the last overt OGIB results in a higher diagnostic yield, higher therapeutic intervention rate, and shorter hospital stay. Therefore, VCE application with a 48-h cutoff could improve the outcome of patients with overt OGIB.

No MeSH data available.


Related in: MedlinePlus