Pérez-Cuadrado-Robles E, Zamora-Nava L E, Jiménez-García V A, Pérez-Cuadrado-Martínez E
Unidad de Intestino Delgado, Hospital Morales Meseguer, Murcia, España.
Departamento de Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
Rev Gastroenterol Mex (Engl Ed). 2018 Jul-Sep;83(3):238-244. doi: 10.1016/j.rgmx.2017.08.004. Epub 2018 Feb 15.
The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients.
All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed.
Of 2311 patients (mean age: 59.5 ± 19.23 years, 44.48% male), 648 were in the older group and 1663 in the younger group. Gastric transit time was shorter in the older patients (p=0.001), whereas small bowel transit time was shorter in the younger patients (p<0.001). Overall diagnostic yield in the elderly was higher (50.66% vs. 41.19%, p<0.001). Obscure gastrointestinal bleeding was the most frequent indication for capsule endoscopy in the elderly (90.4% vs. 53.77%, p<0.001), achieving a higher diagnostic yield than in the younger population (51.47% vs. 42.76%, p=0.002), whereas Crohn's disease, suspected or known neoplasms/polyps, malabsorption syndrome, and abdominal pain were the indications in the younger patient group. Such indications were rare in the older group. Vascular lesions and active bleeding were more frequently diagnosed in the older patients, whereas ulcers/erosions and mucosal atrophy were more common in the younger patients (p<0.001).
Capsule endoscopy achieved a higher overall diagnostic yield in the elderly patients. Obscure gastrointestinal bleeding indication for capsule endoscopy was much more frequent in the advanced-age group and had a higher diagnostic yield.
老年人口的不断增长以及胶囊内镜的广泛应用导致这些患者接受该检查的数量增多。本研究的目的是评估胶囊内镜在老年患者中的实用性。
将2004年至2016年期间在本中心连续接受胶囊内镜检查的所有患者分为老年组（≥75岁）和年轻组。对检查结果和诊断率进行比较评估。
在2311例患者中（平均年龄：59.5±19.23岁，男性占44.48%），老年组有648例，年轻组有1663例。老年患者的胃传输时间较短（p=0.001），而年轻患者的小肠传输时间较短（p<0.001）。老年患者的总体诊断率较高（50.66%对41.19%，p<0.001）。不明原因的胃肠道出血是老年患者进行胶囊内镜检查最常见的适应证（90.4%对53.77%，p<0.001），其诊断率高于年轻人群（51.47%对42.76%，p=0.002），而克罗恩病、疑似或已知的肿瘤/息肉、吸收不良综合征和腹痛是年轻患者组的适应证。这些适应证在老年组中很少见。老年患者更常诊断出血管病变和活动性出血，而溃疡/糜烂和黏膜萎缩在年轻患者中更常见（p<0.001）。
胶囊内镜在老年患者中总体诊断率较高。胶囊内镜检查的不明原因胃肠道出血适应证在老年组中更为常见，且诊断率更高。
