Long-term outcome of capsule endoscopy in obscure gastrointestinal bleeding: a nationwide analysis

Yang Won Min; Jin Su Kim; Seong Woo Jeon; Yoon Tae Jeen; Jong Pil Im; Dae Young Cheung; Myung-Gyu Choi; Jin-Oh Kim; Kwang Jae Lee; Byong Duk Ye; Ki-Nam Shim; Jeong Seop Moon; Ji Hyun Kim; Sung Pil Hong; Dong Kyung Chang

doi:10.1055/s-0033-1358803

Endoscopy, Table of Contents

Endoscopy 2014; 46(01): 59-65
DOI: 10.1055/s-0033-1358803

Original article

Long-term outcome of capsule endoscopy in obscure gastrointestinal bleeding: a nationwide analysis

Yang Won Min^*

¹Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

,

Jin Su Kim^*

²Seoul St. Mary’s Hospital, College of Medicine, The Catholic University, Seoul, Korea

,

Seong Woo Jeon

³Kyungpook National University Hospital, Daegu, Korea

,

Yoon Tae Jeen

⁴Korea University Hospital, Seoul, Korea

,

Jong Pil Im

⁵Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea

,

Dae Young Cheung

⁶Yoido St. Mary’s Hospital, College of Medicine, The Catholic University, Seoul, Korea

,

Myung-Gyu Choi

²Seoul St. Mary’s Hospital, College of Medicine, The Catholic University, Seoul, Korea

,

Jin-Oh Kim

⁷University of Soonchunhyang, Seoul, Korea

,

Kwang Jae Lee

⁸Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea

,

Byong Duk Ye

⁹University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

,

Ki-Nam Shim

¹⁰Ewha Womans University School of Medicine, Seoul, Korea

,

Jeong Seop Moon

¹¹Inje University Seoul Paik Hospital, Seoul, Korea

,

Ji Hyun Kim

¹²Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

,

Sung Pil Hong

¹³Yonsei University College of Medicine, Seoul, Korea

,

Dong Kyung Chang

¹Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

› Author Affiliations

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.

Full Text

References

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