title: Uncovering the uncertainty: Risk factors and clinical relevance of P1 lesions on small bowel capsule endoscopy of anemic patients.
abstract: OBJECTIVE
  To identify risk factors for P1 lesions on small bowel capsule endoscopy (SBCE) and to describe the natural history of anemic patients with such type of lesions.
  
  
  METHODS
  One hundred patients were consecutively selected for a case-control analysis performed between 37 cases with P1 lesions and 63 controls with negative SBCE. Age, gender, comorbidities and regular medication were collected. Rebleeding, further investigational studies and death were also analyzed during the follow-up.
  
  
  RESULTS
  No significant differences on gender, median age or Charlson index were found between groups. Although no differences were found on the use of proton pump inhibitors, acetylsalicylic acid, anticoagulants or antiplatelet agents, the use of non-steroidal anti-inflammatory drugs (NSAID) was associated with a higher risk of P1 lesions (OR = 12.00, 95%CI: 1.38-104.1). From the 87 patients followed at our center, 39 were submitted to additional studies for investigation of iron-deficiency anemia (IDA), and this was significantly more common in those patients with no findings on SBCE (53.7%vs30.3%,P= 0.033). A total of 29 patients had at least one rebleeding or IDA recurrence episode and 9 patients died of non-anemia related causes but no differences were found between cases and controls.
  
  
  CONCLUSIONS
  P1 lesions are commonly found in patients with IDA submitted to SBCE. The use of NSAID seems to be a risk factor for P1 lesions. The outcomes of patients with P1 lesions do not differ significantly from those with P0 lesions or normal SBCE.
authors: Tiago Cúrdia Gonçalves, Mara Barbosa, Bruno Rosa, Maria João Moreira, José Cotter, Gastroenterology Department, Hospital da Senhora da Oliveira, 4835-044 Creixomil, Guimarães, Portugal.
authors: Tiago
authors: T
authors: Cúrdia Gonçalves
authors: Tiago Cúrdia Gonçalves, Mara Barbosa, Bruno Rosa, Maria João Moreira, José Cotter, Gastroenterology Department, Hospital da Senhora da Oliveira, 4835-044 Creixomil, Guimarães, Portugal.
authors: Mara
authors: M
authors: Barbosa
authors: Tiago Cúrdia Gonçalves, Mara Barbosa, Bruno Rosa, Maria João Moreira, José Cotter, Gastroenterology Department, Hospital da Senhora da Oliveira, 4835-044 Creixomil, Guimarães, Portugal.
authors: Bruno
authors: B
authors: Rosa
authors: Tiago Cúrdia Gonçalves, Mara Barbosa, Bruno Rosa, Maria João Moreira, José Cotter, Gastroenterology Department, Hospital da Senhora da Oliveira, 4835-044 Creixomil, Guimarães, Portugal.
authors: Maria João
authors: MJ
authors: Moreira
authors: Tiago Cúrdia Gonçalves, Mara Barbosa, Bruno Rosa, Maria João Moreira, José Cotter, Gastroenterology Department, Hospital da Senhora da Oliveira, 4835-044 Creixomil, Guimarães, Portugal.
authors: José
authors: J
authors: Cotter
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000740:Anemia / Q000150:complications*; D053704:Capsule Endoscopy; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006470:Hemorrhage; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D035501:Uncertainty
keywords: Iron-deficiency anemia; P1 lesions; Rebleeding; Risk factors; Small bowel capsule endoscopy