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

Kim, Seung Han; Keum, Bora; Chun, Hoon Jai; Yoo, In Kyung; Lee, Jae Min; Lee, Jong Soo; Nam, Seung Joo; Choi, Hyuk Soon; Kim, Eun Sun; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck
Endoscopy international open
2015Aug ; 3 ( 4 ) :E334-8.
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Kim, Seung Han - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Keum, Bora - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Chun, Hoon Jai - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Yoo, In Kyung - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Lee, Jae Min - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Lee, Jong Soo - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Nam, Seung Joo - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Choi, Hyuk Soon - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Kim, Eun Sun - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Seo, Yeon Seok - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Jeen, Yoon Tae - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Lee, Hong Sik - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Um, Soon Ho - Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Republic of Korea.
Kim, Chang Duck - 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 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 groups, respectively (P?=?0.028). The mean lengths of hospital stay in the ?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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Performing VCE within 2 days could improve the management of these patients by allowing for a more rapid, appropriate, and cost-effective therapeutic plan.
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DOI
10.1055/s-0034-1391852.
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ICD 03
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