Inpatient capsule endoscopy leads to frequent incomplete small bowel examinations

AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient status.METHODS： We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2012-09, Vol.18 (36), p.5051-5057
Main Authors: Yazici, Cemal, Losurdo, John, Brown, Michael D, Oosterveen, Scott, Rahimi, Robert, Keshavarzian, Ali, Bozorgnia, Leila, Mutlu, Ece
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Brief
Capsule Endoscopy - adverse effects
Female
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Transit
Humans
Inpatients
Intestine, Small - pathology
Logistic Models
Logistic回归分析
Male
Middle Aged
Retrospective Studies
Risk Factors
不完全性
位置数据
小肠
有机磷农药
检查
胶囊
鸡传染性法氏囊病
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Summary:AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient status.METHODS： We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient （OP）, 70 in-patient （IP）], CE indications, findings, location of the patients [IP vs OP and intensive care unit （ICU） vs general medical floor （GMF）] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 （Chicago, IL）. Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS： The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs （P = 0.07）. The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding （OGB） was significantly more com- mon for the IP CE （P = 0.0001）, while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams （P = 0.002 and P = 0.01, respec- tively）. Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel （SB） in 6/70 IPs and 8/264 OPs （P = 0.04）. The capsule never reached the cecum in 31.4% （22/70） of IP vs 9.5% （25/ 264） of OP ex- aminations （P 〈 0.001）. The mean gastric transit time （GTT） was delayed in IPs compared to OPs, 98.5 ± 139.5 min vs 60.4 ± 92.6 min （P = 0.008）. Minimal SB transit time was significantly prolonged in the IP com- pared to the OP setting [IP = 275.1±111.6 min vs OP = 244.0 ± 104.3 min （P = 0.037）]. CECR was also sig- nificantly higher in the subgroup of patients with OGB who had OP vs IP exams （95% vs 80% respectively, P = 0.001）. The proportion of patients with incomplete exams was higher in the ICU （n = 7/13, 54%） as com- pared to the GMF （n = 15/57, 26%） （P = 0.05
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v18.i36.5051