Factors associated with diagnosis of obscure gastrointestinal bleeding by video capsule enteroscopy.
OBJECTIVE
Capsule enteroscopy (CE) is the best noninvasive tool to explore the entire small bowel of patients with obscure gastrointestinal bleeding (OGIB); it has a diagnostic yield of 40%-80%. However, little is known about the factors associated with a diagnosis of OGIB by CE.


METHODS
We analyzed data from 911 consecutive patients who underwent CE for OGIB from January 2004 to January 2010. Results from upper and lower gastrointestinal endoscopy examinations were negative in all patients. CE findings were recorded. Features of patients that were associated with diagnosis of OGIB by CE were identified by using logistic regression.


RESULTS
Based on CE, 509 patients (56%) had a confirmed lesion responsible for the OGIB: 203 had disease of the small bowel (22%), 88 had ulcerations (10%), 70 had tumors (8%), 24 had varices (2%), 6 had diverticula (0.5%), and 118 had what appeared to be bleeding lesions of the esophagus or stomach (10.6%) or colon (2%). Factors independently associated with a diagnosis of OGIB by CE were age >60 years (odds ratio [OR], 1.2), male sex, history of overt bleeding (OR, 3.8), and current hospitalization (OR, 1.4). Women were less likely to be diagnosed with OGIB by CE (OR, 0.7).


CONCLUSIONS
A history of overt bleeding is the factor most strongly associated with a diagnosis of OGIB by CE. Male sex, age >60 years, and inpatient status were also independent predictors of positive diagnosis by CE.
Gastroenterology Department, Digestive Endoscopy Unit, Rouen University Hospital and Institut National de la Sante et de la recherche Medicale U-1073, University of Rouen, Rouen, France.
Lucie
L
Lepileur
Xavier
X
Dray
Michel
M
Antonietti
Isabelle
I
Iwanicki-Caron
Sébastien
S
Grigioni
Ulriikka
U
Chaput
Aude
A
Di-Fiore
Raied
R
Alhameedi
Philippe
P
Marteau
Philippe
P
Ducrotté
Stéphane
S
Lecleire
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D012737:Sex Factors; D055815:Young Adult