title: Outcome in obscure gastrointestinal bleeding after capsule endoscopy.
abstract: OBJECTIVE
  To investigate the clinical impact of capsule endoscopy (CE) after an obscure gastrointestinal bleeding (OGIB) episode, focusing on diagnostic work-up, follow-up and predictive factors of rebleeding.
  
  
  METHODS
  Patients who were referred to Hospital del Mar (Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid anti-inflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings (significant or non-significant), work-up and patient outcomes were analyzed from electronic charts. Variables were compared by χ (2) analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-Meier curves and Cox regression model.
  
  
  RESULTS
  There were 105 patients [45.7% women, median age of 72 years old (interquartile range 56-79)] and a median follow-up of 326 d (interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1% (55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients (69.5%), OGIB was resolved. Multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios (HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above (HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE (HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding.
  
  
  CONCLUSIONS
  One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions.
authors.affiliation: Alex Cañas-Ventura, Lucia Márquez, Xavier Bessa, Josep Maria Dedeu, Marc Puigvehí, Sílvia Delgado-Aros, Ines Ana Ibáñez, Agustin Seoane, Luis Barranco, Felipe Bory, Montserrat Andreu, Department of Gastroenterology, Hospital del Mar Research Institute, Pompeu Fabra University, 08003 Barcelona, Spain.
authors.forename: Alex
authors.initials: A
authors.lastname: Cañas-Ventura
authors.forename: Lucia
authors.initials: L
authors.lastname: Márquez
authors.forename: Xavier
authors.initials: X
authors.lastname: Bessa
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Dedeu
authors.forename: Marc
authors.initials: M
authors.lastname: Puigvehí
authors.forename: Sílvia
authors.initials: S
authors.lastname: Delgado-Aros
authors.forename: Ines Ana
authors.initials: IA
authors.lastname: Ibáñez
authors.forename: Agustin
authors.initials: A
authors.lastname: Seoane
authors.forename: Luis
authors.initials: L
authors.lastname: Barranco
authors.forename: Felipe
authors.initials: F
authors.lastname: Bory
authors.forename: Montserrat
authors.initials: M
authors.lastname: Andreu
authors.forename: Begoña
authors.initials: B
authors.lastname: González-Suárez
keywords: Angiodysplasia; Capsule endoscopy; Enteroscopy; Obscure gastrointestinal bleeding; Small bowel