Division of Gastroenterology, Department of Medicine, Northwell Health, New York, NY, USA.
Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
BMC Gastroenterol. 2022 May 12;22(1):236. doi: 10.1186/s12876-022-02323-9.
Capsule endoscopy (CE) provides a novel approach to evaluate obscure gastrointestinal bleeding. Yet CE is not routinely utilized in the inpatient setting for a variety of reasons. We sought to identify factors that predict complete CE and diagnostically meaningful CE, as well as assess the impact of inpatient CE on further hospital management.1 na d2 METHODS: We conducted a retrospective review of patients undergoing inpatient CE at a tertiary referral, academic center over a 3 year period. We analyzed data on patient demographics, medical history, endoscopic procedures, hospital course, and results of CE. The primary outcome was complete CE and the secondary outcome was positive findings of pathology on CE.
131 patients were included (56.5% were men 43.5% women, median age of 71.0 years). Overall, CE was complete in 77.1% of patients. Complete CE was not related to motility risk factors, gender, or administration modality. Patients with incomplete CE tended to be older, have lower BMI, and Caucasian, however results did not reach statistical significance (p = 0.06; p = 0.06; p = 0.08 respectively). Positive CE was noted in 73.3% of patients, with 35.1% of all patients having active bleeding. Positive CE was not associated with AVM risk factors or medication use. 28.0% of patients underwent subsequent hospital procedures, among which 67.6% identified the same pathology seen on CE.
Contrary to previous studies, we found the majority of inpatient CEs were complete and positive for pathology. We found high rates of correlation between CE and subsequent procedures. The use of CE in the inpatient setting helps to guide the diagnosis and treatment of hospitalized patients with obscure gastrointestinal bleeding.
胶囊内镜（CE）为评估不明原因胃肠道出血提供了一种新方法。然而，由于各种原因，CE 并未常规用于住院患者。我们试图确定预测 CE 完全和诊断有意义的因素，以及评估住院 CE 对进一步医院管理的影响。1 na d2
我们对在一所三级转诊学术中心接受住院 CE 的患者进行了回顾性研究，时间为 3 年。我们分析了患者人口统计学、病史、内镜检查、住院过程和 CE 结果的数据。主要结果是 CE 完全，次要结果是 CE 上的病理学阳性发现。
共纳入 131 例患者（56.5%为男性，43.5%为女性，中位年龄为 71.0 岁）。总体而言，77.1%的患者 CE 完全。CE 完全与运动障碍危险因素、性别或给药方式无关。CE 不完全的患者年龄较大、BMI 较低且为白人，但结果未达到统计学意义（p=0.06；p=0.06；p=0.08 分别）。73.3%的患者 CE 阳性，所有患者中有 35.1%存在活动性出血。CE 阳性与 AVM 危险因素或药物使用无关。28.0%的患者随后进行了医院程序，其中 67.6%的患者确定了与 CE 相同的病理。
与之前的研究相反，我们发现大多数住院 CE 都是完全的，且与病理学有关。我们发现 CE 与随后的程序之间存在高度相关性。在住院环境中使用 CE 有助于指导不明原因胃肠道出血住院患者的诊断和治疗。
