St Paul's Hospital, University of British Columbia, 770-1190 Hornby Street, Vancouver, British Columbia V6Z 2K5, Canada.
World J Gastroenterol. 2010 Nov 14;16(42):5329-33. doi: 10.3748/wjg.v16.i42.5329.
To identify patient risk factors associated with incomplete small bowel capsule endoscopy (CE) studies.
Data from all CE procedures performed at St. Paul's Hospital in Vancouver, British Columbia, Canada, between December 2001 and June 2008 were collected and analyzed on a retrospective basis. Data collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure, hospitalization, diabetes mellitus with or without end organ damage, limitations in mobility, renal insufficiency, past history of bowel obstruction, abdominal surgery, abdominal radiation therapy and opiate use. Risk factors were analyzed using a univariable and multivariable logistic regression model.
From a total of 535 CE procedures performed, 158 were incomplete (29.5%). The univariable analysis showed that CE procedures performed for overt gastrointestinal bleeding (P = 0.002), and for patients with a prior history of abdominal surgery (P = 0.023) or bowel obstruction (P = 0.023) were significantly associated with incomplete CE studies. Patients on opiate medications (P = 0.094) as well as hospitalized patients (P = 0.054) were not statistically significant, but did show a trend towards incomplete CE. The multivariable analysis showed that independent risk factors for an incomplete CE procedure include prior history of bowel obstruction [odds ratios (OR) 2.77, P = 0.02, 95% confidence intervals (CI): 1.17-6.56] and procedures performed for gastrointestinal bleeding (Occult OR 2.04, P = 0.037, 95% CI: 1.04-4.02 and Overt OR 2.69, P = 0.002, 95% CI: 1.44-5.05). Patients with a prior history of abdominal surgery (OR 1.46, P = 0.068, 95% CI: 0.97-2.19), those taking opiate medications (OR 1.54, P = 0.15, 95% CI: 0.86-2.76) and hospitalized patients (OR 1.82, P = 0.124, 95% CI: 0.85-3.93) showed a trend towards statistical significance.
We have identified a number of risk factors for incomplete CE procedures that can be used to risk-stratify patients and guide interventions to improve completion rates.
确定与小肠胶囊内镜（CE）检查不完整相关的患者风险因素。
对 2001 年 12 月至 2008 年 6 月期间在不列颠哥伦比亚省温哥华圣保罗医院进行的所有 CE 程序的数据进行回顾性收集和分析。完整和不完整 CE 研究组的数据收集包括患者人口统计学特征以及一些潜在的 CE 不完整风险因素，包括检查的适应证、住院、有或无终末器官损害的糖尿病、活动能力受限、肾功能不全、既往肠梗阻、腹部手术、腹部放射治疗和阿片类药物使用史。使用单变量和多变量逻辑回归模型分析风险因素。
在总共进行的 535 例 CE 检查中，有 158 例（29.5%）不完整。单变量分析显示，CE 检查用于明显胃肠道出血（P=0.002），以及用于既往有腹部手术史（P=0.023）或肠梗阻史（P=0.023）的患者，与不完整的 CE 研究显著相关。正在使用阿片类药物的患者（P=0.094）和住院患者（P=0.054）虽然没有统计学意义，但确实显示出 CE 不完整的趋势。多变量分析显示，CE 检查不完整的独立风险因素包括既往有肠梗阻史[比值比（OR）2.77，P=0.02，95%置信区间（CI）：1.17-6.56]和因胃肠道出血进行的检查[隐匿性 OR 2.04，P=0.037，95%CI：1.04-4.02 和显性 OR 2.69，P=0.002，95%CI：1.44-5.05]。既往有腹部手术史的患者（OR 1.46，P=0.068，95%CI：0.97-2.19）、使用阿片类药物的患者（OR 1.54，P=0.15，95%CI：0.86-2.76）和住院患者（OR 1.82，P=0.124，95%CI：0.85-3.93）有统计学意义的趋势。
我们已经确定了一些与 CE 检查不完整相关的风险因素，可用于对患者进行风险分层并指导干预措施以提高完成率。
