title: Factors associated with incomplete small bowel capsule endoscopy studies.
abstract: OBJECTIVE
  To identify patient risk factors associated with incomplete small bowel capsule endoscopy (CE) studies.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: St Paul's Hospital, University of British Columbia, 770-1190 Hornby Street, Vancouver, British Columbia V6Z 2K5, Canada.
authors.forename: Mitchell M
authors.initials: MM
authors.lastname: Lee
authors.forename: Andrew
authors.initials: A
authors.lastname: Jacques
authors.forename: Eric
authors.initials: E
authors.lastname: Lam
authors.forename: Ricky
authors.initials: R
authors.lastname: Kwok
authors.forename: Pardis
authors.initials: P
authors.lastname: Lakzadeh
authors.forename: Ajit
authors.initials: A
authors.lastname: Sandhar
authors.forename: Brandon
authors.initials: B
authors.lastname: Segal
authors.forename: Sigrid
authors.initials: S
authors.lastname: Svarta
authors.forename: Joanna
authors.initials: J
authors.lastname: Law
authors.forename: Robert
authors.initials: R
authors.lastname: Enns
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult