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. 2015 Aug;3(4):E334-8.
doi: 10.1055/s-0034-1391852. Epub 2015 May 5.

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

Seung Han Kim  1 , Bora Keum  1 , Hoon Jai Chun  1 , In Kyung Yoo  1 , Jae Min Lee  1 , Jong Soo Lee  1 , Seung Joo Nam  1 , Hyuk Soon Choi  1 , Eun Sun Kim  1 , Yeon Seok Seo  1 , Yoon Tae Jeen  1 , Hong Sik Lee  1 , Soon Ho Um  1 , Chang Duck Kim  1
Affiliations

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

Seung Han Kim et al. Endosc Int Open. 2015 Aug.

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.

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Conflict of interest statement

Competing interests: None

Figures

Fig. 1
Fig. 1
Study design flow chart. VCE, video capsule endoscopy; OGIB, obscure gastrointestinal bleeding.
Fig. 2
Fig. 2
Diagnostic yield (%) for detecting active bleeding and/or angiodysplasia with respect to the time (days) after the last gastrointestinal bleeding.
Fig. 3
Fig. 3
Length of hospital stay (days) for the < 48-h and > 48-h groups.
See this image and copyright information in PMC

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