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inpatient capsule endoscopy leads to frequent incomplete small bowel examinations

World Journal of Gastroenterology 2012年第36期18卷 5051-5057页

作者： Cemal Yazici John Losurdo Michael D Brown Scott Oosterveen Robert Rahimi Ali Keshavarzian Leila Bozorgnia Ece Mutlu Department of Medicine Mercy Hospital and Medical CenterChicagoIL 60616United States Division of Digestive Diseases and Nutrition Rush University Medical CenterChicagoIL 60612United States WellSpan Gastroenterology YorkPA 17403United States Division of Digestive and Liver Diseases University of Texas Southwestern Medical CenterDallasTX 75390United States Department of Pediatrics Los Angeles County-University of Southern California HospitalLos AngelesCA 9003United States

AIM： To examine the predictive factors of capsule en- doscopy （CE） completion rate （CECR） including the ef- fect of inpatient and outpatient ***： We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005. Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the pro- cedure. CE exams were reviewed by two physicians who were unaware of the study hypotheses. After retrospective analysis, 21 cases were excluded due to capsule malfunction, prior gastric surgery, endoscopic capsule placement or insufficient data. Of the remain- ing 334 exams [264 out-patient （OP）, 70 in-patient （IP）], CE indications, findings, location of the patients [IP vs OP and intensive care unit （ICU） vs general medical floor （GMF）] and gastrointestinal transit times were analyzed. Statistical analysis was completed us- ing SPSS version 17 （Chicago, IL）. Chi-square, t test or fisher exact-tests were used as appropriate. Multivari- ate logistic regression analysis was used to identify variables associated with incomplete CE exams. RESULTS： The mean age for the entire study popula- tion was 54.7 years. Sixty-one percent of the study population was female, and gender was not different between IPs vs OPs （P = 0.07）. The overall incomplete CECR was 14% in our study. Overt obscure gastroin- testinal bleeding （OGB） was significantly more com- mon for the IP CE （P = 0.0001）, while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams （P = 0.002 and P = 0.01, respec- tively）. Occult OGB was the most common indication and arteriovenous malformations were the most com- mon finding both in the IPs and OPs. The capsule did not enter the small bowel （SB） in 6/70 IPs and 8/264 OPs （P = 0.04）. The capsule never reached the cecum in 31.4% （22/70） of IP vs 9.5% （25/ 264） of OP ex- aminations （P 〈 0.001）. The mean gastric transit time （GTT） was delayed

关键词： Capsule endoscopy Completion rate inpa-tient Outpatient Hospitalization

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