Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
Saudi J Gastroenterol. 2020 Jan-Feb;26(1):53-60. doi: 10.4103/sjg.SJG_415_19.
BACKGROUND/AIM: There are limited data evaluating the impact of inpatient video capsule endoscopy (VCE) on the need for therapeutic interventions in hospitalized patients with obscure gastrointestinal bleeding (OGIB). The objective of this study was to determine the impact of inpatient VCE on the need for therapeutic interventions and rehospitalization for recurrent bleeding.
Hospitalized patients who underwent VCE for OGIB indication were retrospectively included. Clinical data were collected including therapeutic interventions performed after VCE. Specific therapeutic interventions were defined as the medical, endoscopic, or surgical treatment directly targeting the cause of OGIB. Patients were followed up to determine the rate of rehospitalization.
A total of 48 inpatient VCE were identified, of which 43 VCE were performed for OGIB indication and were included for analysis. The completion rate and the diagnostic yield were 78.5% and 55.8%, respectively. Subsequent specific therapeutic interventions were performed in 65.2% and 5.8% of patients with positive and negative VCE, respectively (P < 0.001). After a median follow up of 30 months (minimum 12, maximum 58), rehospitalization for recurrent bleeding occurred in 30.4% and 17% of patients with positive and negative VCE, respectively. Patients with angiodysplasia on VCE were significantly more likely to be readmitted (P = 0.02). Throughout the course of the follow-up, only 2 (11.7%) patients with negative VCE underwent specific therapeutic interventions.
Inpatient VCE is an effective tool to identify patients who need specific therapeutic interventions. Patients with negative VCE are unlikely to be readmitted or require specific therapeutic interventions in the index admission.
背景/目的：评估住院患者行视频胶囊内镜（VCE）对不明原因胃肠道出血（OGIB）患者治疗干预需求的影响的数据有限。本研究旨在确定住院 VCE 对治疗干预和复发性出血再住院需求的影响。
回顾性纳入因 OGIB 行 VCE 的住院患者。收集包括 VCE 后进行的治疗干预在内的临床数据。特定治疗干预被定义为直接针对 OGIB 病因的药物、内镜或手术治疗。对患者进行随访以确定再住院率。
共确定 48 例住院 VCE，其中 43 例因 OGIB 行 VCE 并纳入分析。VCE 的完成率和诊断率分别为 78.5%和 55.8%。阳性和阴性 VCE 患者分别有 65.2%和 5.8%接受了后续特定治疗干预（P < 0.001）。中位随访 30 个月（最小 12 个月，最大 58 个月）后，阳性和阴性 VCE 患者的复发性出血再住院率分别为 30.4%和 17%。VCE 上有血管发育不良的患者更有可能再入院（P = 0.02）。在整个随访过程中，仅 2 例（11.7%）阴性 VCE 患者接受了特定治疗干预。
住院 VCE 是识别需要特定治疗干预的患者的有效工具。阴性 VCE 的患者在指数入院期间不太可能再住院或需要特定的治疗干预。
