Min, Yang Won; Kim, Jin Su; Jeon, Seong Woo; Jeen, Yoon Tae; Im, Jong Pil; Cheung, Dae Young; Choi, Myung-Gyu; Kim, Jin-Oh; Lee, Kwang Jae; Ye, Byong Duk; Shim, Ki-Nam; Moon, Jeong Seop; Kim, Ji Hyun; Hong, Sung Pil; Chang, Dong Kyung
Endoscopy
2014Jan ; 46 ( 1 ) :59-65.
PMID : 24254387
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Min, Yang Won - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim, Jin Su - Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
Jeon, Seong Woo - Kyungpook National University Hospital, Daegu, Korea.
Jeen, Yoon Tae - Korea University Hospital, Seoul, Korea.
Im, Jong Pil - Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Cheung, Dae Young - Yoido St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
Choi, Myung-Gyu - Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
Kim, Jin-Oh - University of Soonchunhyang, Seoul, Korea.
Lee, Kwang Jae - Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Ye, Byong Duk - University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Shim, Ki-Nam - Ewha Womans University School of Medicine, Seoul, Korea.
Moon, Jeong Seop - Inje University Seoul Paik Hospital, Seoul, Korea.
Kim, Ji Hyun - Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Hong, Sung Pil - Yonsei University College of Medicine, Seoul, Korea.
Chang, Dong Kyung - Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
ABSTRACT
BACKGROUND AND STUDY AIMS: The clinical impact of video capsule endoscopy (VCE) in patients with obscure gastrointestinal bleeding (OGIB) remains undetermined. The aim of this study was to evaluate the long-term clinical impact of VCE in patients with OGIB using a nationwide registry. PATIENTS AND
METHODS: Data from 305 patients who underwent VCE for OGIB from 13 hospitals in Korea between January 2006 and March 2009 were analyzed. Prospectively collected VCE registry data were reviewed, and follow-up data were collected by chart review and telephone interviews with patients. Multivariate regression analyses using hazard ratios (HR) were performed to determine risk factors for rebleeding.
RESULTS: Significant findings were detected in 157 patients (51.5%). After VCE, interventional treatment was performed in 36 patients (11.8%). The overall rebleeding rate was 19.0% during a mean (±SD) follow-up of 38.7±26.4 months. Rebleeding rate did not differ by positive VCE results or application of interventional treatment. Multivariate analysis revealed that angiodysplasia (HR 1.82; 95% confidence interval [CI] 1.04-3.20; P=0.037) and duration of OGIB >3 months (HR 1.64; 95%CI 1.10-2.46; P=0.016) were independent prognostic factors associated with rebleeding. In a subgroup analysis of patients taking anticoagulants, patients who discontinued drugs after VCE showed a lower rebleeding rate than those who did not discontinue this therapy (P=0.019).
CONCLUSIONS: VCE did not have a significant impact on the long-term outcome of patients with OGIB. Patients with angiodysplasia on VCE or OGIB>3 months need to be closely followed even after interventional treatment. In patients who are taking anticoagulants, discontinuation of drugs is necessary in order to lower the risk of rebleeding. CI - ??Georg Thieme Verlag KG Stuttgart · New York.
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MESH
Adult, Aged, Angiodysplasia/complications, Anticoagulants/therapeutic use, *Capsule Endoscopy, Female, Gastrointestinal Hemorrhage/*diagnosis/*etiology/therapy, Humans, Male, Middle Aged, Recurrence, Registries, Republic of Korea, Risk Factors, Time Factors
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