title: Risk stratification of upper GI bleeding with an esophageal capsule.
abstract: BACKGROUND
  Analysis of upper GI bleeding (UGIB) presentations to our institutions suggests that many patients admitted for endoscopic investigation could be managed safely as outpatients.
  
  
  OBJECTIVE
  To learn whether an esophageal capsule could identify a low-risk group of patients with UGIB who could safely wait for elective EGD.
  
  
  METHODS
  Diagnostic, nonrandomized, single-blind (investigator) study.
  
  
  METHODS
  Three tertiary-care referral centers.
  
  
  METHODS
  Eighty-three consecutive adult patients referred for management of UGIB.
  
  
  METHODS
  A capsule endoscopy (CE) was performed before EGD for the investigation and management of UGIB.
  
  
  METHODS
  Detection rates of UGIB source and identification of a low-risk group of patients who would have been suitable for outpatient EGD based on CE findings.
  
  
  RESULTS
  In total, 62 of 83 patients (75%) had a cause for bleeding identified. Findings were concordant across both modalities in 34 patients (55%). Twenty-one patients (38%) with positive EGD results had negative CE results, 7 of whom were due to lack of duodenal visualization alone. However, 7 of 28 patients (25%) with normal EGD results had positive CE results. The subgroup of patients with duodenal visualization on CE, 23 of 25 (92%), were concordant with EGD for low-risk lesions that would have been suitable for outpatient management.
  
  
  CONCLUSIONS
  Low duodenal visualization rates with CE and low concordance between EGD and CE.
  
  
  CONCLUSIONS
  Although CE is not currently ready to be used as a triage tool, when duodenal visualization was achieved CE correlated well with EGD findings and identified 92% of patients who may have been managed as outpatients.
authors: Department of Gastroenterology, Austin Health, Heidelberg, Victoria, Australia.
authors: Sujievvan
authors: S
authors: Chandran
authors: Adam
authors: A
authors: Testro
authors: Paul
authors: P
authors: Urquhart
authors: Richard
authors: R
authors: La Nauze
authors: Sim
authors: S
authors: Ong
authors: Edward
authors: E
authors: Shelton
authors: Hamish
authors: H
authors: Philpott
authors: Siddarth
authors: S
authors: Sood
authors: Rhys
authors: R
authors: Vaughan
authors: William
authors: W
authors: Kemp
authors: Gregor
authors: G
authors: Brown
authors: Paul
authors: P
authors: Froomes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D015331:Cohort Studies; D016145:Endoscopy, Digestive System; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D016037:Single-Blind Method; D055815:Young Adult