title: [Diagnostic yield of video capsule endoscopy in premenopausal women with iron-deficiency anemia].
abstract: Clinical practice guidelines recommend video capsule endoscopy (VCE) studies in patients with iron-deficiency anemia (IDA) after conventional upper and lower endoscopies but there is a need for studies demonstrating the diagnostic yield, clinical impact, and cost in some patient subgroups.
  
  
  OBJECTIVE
  1.To determine the diagnostic yield of VCE in premenopausal women with IDA compared with that in men and postmenopausal women. 2. To identify the presence of VCE predictors in premenopausal women. 3. To estimate the cost-clinical impact relationship associated with VCE in this indication.
  
  
  METHODS
  We retrospectively analyzed 408 patients who underwent VCE. Patients with IDA were enrolled (premenopausal, postmenopausal women, and men), with previous normal work-up by conventional endoscopies.
  
  
  RESULTS
  A total of 249 patients were enrolled: 131 women (52.6%), of which 51 were premenopausal and 80 were post-menopausal, and 118 men. The mean age was 60.7±16 years. The diagnostic yield of VCE for the diagnosis of IDA was 44.6% (95% CI 39.9 - 50.8). Diagnostic yield was 50.8% vs 38.9% in men vs women (p=0.05) and was 55% vs 13.7% in postmenopausal vs premenopausal women (p<0.001). No predictors of small bowel lesions were found in premenopausal women. The most common findings in the postmenopausal group were angioectasias (70.5%) and erosions (57.1%) in the premenopausal group. The cost in premenopausal women was 44.727€ and 86.3% of the procedures had no clinical impact.
  
  
  CONCLUSIONS
  The diagnostic yield of VCE is low in the etiological study of IDA in premenopausal women and there is no cost-effectiveness in relation to clinical impact. No predictors of small bowel lesions were found in this group.
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España. Electronic address: mariad.garrido@ssib.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Garrido Durán
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Iyo Miyashiro
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Claudia
authors.initials: C
authors.lastname: Páez Cumpa
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Sam
authors.initials: S
authors.lastname: Khorrami Minaei
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Alicia
authors.initials: A
authors.lastname: Erimeiku Barahona
authors.affiliation: Servicio de Digestivo, Hospital Universitario Son Espases, Palma de Mallorca, España.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Llompart Rigo
mesh_terms: D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000209:etiology*; D016888:Angiodysplasia / Q000150:complications / Q000000981:diagnostic imaging; D053704:Capsule Endoscopy / Q000191:economics; D003362:Cost-Benefit Analysis; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000000981:diagnostic imaging; D017698:Postmenopause; D011237:Predictive Value of Tests; D017697:Premenopause; D012189:Retrospective Studies
keywords: Anemia ferropénica; Capsule endoscopy; Cápsula endoscópica; Iron deficiency anemia; Mujeres premenopáusicas; Pre-menopausal women