title: Long-term outcome of capsule endoscopy in obscure gastrointestinal bleeding: a nationwide analysis.
abstract: OBJECTIVE
  The clinical impact of video capsule endoscopy (VCE) in patients with obscure gastrointestinal bleeding (OGIB) remains undetermined. The aim of this study was to evaluate the long-term clinical impact of VCE in patients with OGIB using a nationwide registry.
  
  
  METHODS
  Data from 305 patients who underwent VCE for OGIB from 13 hospitals in Korea between January 2006 and March 2009 were analyzed. Prospectively collected VCE registry data were reviewed, and follow-up data were collected by chart review and telephone interviews with patients. Multivariate regression analyses using hazard ratios (HR) were performed to determine risk factors for rebleeding.
  
  
  RESULTS
  Significant findings were detected in 157 patients (51.5%). After VCE, interventional treatment was performed in 36 patients (11.8%). The overall rebleeding rate was 19.0% during a mean (±SD) follow-up of 38.7±26.4 months. Rebleeding rate did not differ by positive VCE results or application of interventional treatment. Multivariate analysis revealed that angiodysplasia (HR 1.82; 95% confidence interval [CI] 1.04-3.20; P=0.037) and duration of OGIB >3 months (HR 1.64; 95%CI 1.10-2.46; P=0.016) were independent prognostic factors associated with rebleeding. In a subgroup analysis of patients taking anticoagulants, patients who discontinued drugs after VCE showed a lower rebleeding rate than those who did not discontinue this therapy (P=0.019).
  
  
  CONCLUSIONS
  VCE did not have a significant impact on the long-term outcome of patients with OGIB. Patients with angiodysplasia on VCE or OGIB>3 months need to be closely followed even after interventional treatment. In patients who are taking anticoagulants, discontinuation of drugs is necessary in order to lower the risk of rebleeding.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yang Won
authors.initials: YW
authors.lastname: Min
authors.affiliation: Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
authors.forename: Jin Su
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.affiliation: Korea University Hospital, Seoul, Korea.
authors.forename: Yoon Tae
authors.initials: YT
authors.lastname: Jeen
authors.affiliation: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.affiliation: Yoido St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
authors.forename: Dae Young
authors.initials: DY
authors.lastname: Cheung
authors.affiliation: Seoul St. Mary's Hospital, College of Medicine, The Catholic University, Seoul, Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: University of Soonchunhyang, Seoul, Korea.
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kwang Jae
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Byong Duk
authors.initials: BD
authors.lastname: Ye
authors.affiliation: Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Shim
authors.affiliation: Inje University Seoul Paik Hospital, Seoul, Korea.
authors.forename: Jeong Seop
authors.initials: JS
authors.lastname: Moon
authors.affiliation: Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sung Pil
authors.initials: SP
authors.lastname: Hong
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Kyung
authors.initials: DK
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D016888:Angiodysplasia / Q000150:complications; D000925:Anticoagulants / Q000627:therapeutic use; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea; D012307:Risk Factors; D013997:Time Factors
chemical_list: D000925:Anticoagulants