title: Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study.
abstract: BACKGROUND
  Diagnostic yield of video capsule endoscopy (VCE) may be higher if it is performed closer to the time of overt obscure GI bleeding (OOGIB).
  
  
  OBJECTIVE
  To evaluate the diagnostic yield of VCE and rate of therapeutic intervention for OOGIB for inpatients and outpatients with respect to timing of the intervention.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary academic center.
  
  
  METHODS
  Patients who had VCE for OOGIB between August 2008 and August 2010.
  
  
  METHODS
  VCE for inpatients versus outpatients.
  
  
  METHODS
  Diagnostic yield and rate of therapeutic intervention for inpatients versus outpatients.
  
  
  RESULTS
  One hundred forty-four inpatients (65 women) and 116 outpatients (49 women) were included. Diagnostic yield was 65.9% for inpatients versus 53.4% for outpatients (P = .054). Inpatients were divided into those who had VCE within 3 days (<3 days; n = 90) of admission versus after 3 days (>3 days; n = 54). Active bleeding and/or an angioectasia was found in 44.4% of the <3-day group compared with 27.8% of the >3-day group (P = .046) versus 25.8% of the outpatients. Therapeutic intervention was performed in 18.9% of the <3-day group versus 7.4% of the >3-day group (P = .046) versus 10.3% of outpatients. Diagnostic yield and therapeutic intervention rate between the >3-day group and outpatients were not significantly different. Length of stay (days) was less in the <3-day cohort, at 6.1 versus 10.3 in the >3-day cohort (P < .0001).
  
  
  CONCLUSIONS
  Long-term outcomes were not studied. This was a retrospective study.
  
  
  CONCLUSIONS
  Early deployment of VCE within 3 days of admission results in a higher diagnostic yield and therapeutic intervention rate and an associated reduction of length of stay.
authors: University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA.
authors: Anupam
authors: A
authors: Singh
authors: Christopher
authors: C
authors: Marshall
authors: Biswashree
authors: B
authors: Chaudhuri
authors: Chidimma
authors: C
authors: Okoli
authors: Anne
authors: A
authors: Foley
authors: Sharina D
authors: SD
authors: Person
authors: Kanishka
authors: K
authors: Bhattacharya
authors: David R
authors: DR
authors: Cave
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D054079:Vascular Malformations / Q000150:complications / Q000175:diagnosis