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Published on: August 1, 2019
Impact of capsule endoscopy findings on patient outcomes
Stephen Kim1, Prashant S Kedia, David L Jaffe
1Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Background And Aims:
There is limited data on the impact of capsule endoscopy (CE) findings on patient outcomes. The aim of our study is to evaluate the impact of CE findings on further diagnostic work-up, treatment, and symptom resolution.
Methods:
A retrospective chart review of patients who underwent CE at a single tertiary care center over a 3-year period was performed. CE findings were classified as positive, suspicious, or negative. Therapeutic interventions were medical, endoscopic, surgical, other, or none. Symptoms were considered resolved when the patient had cessation of symptoms for at least 6 months post-CE.
Results:
A total of 193 patients were studied. The overall diagnostic yield of CE was 37%. There were 97 (50%) patients who had further diagnostic testing following CE; (40 with positive, 22 with suspicious, 35 with negative CE findings). There were 76% patients who received treatment post-CE (59% with positive, 43% with suspicious, 49% with negative CE findings). Overall symptom resolution was seen in 71% of patients (59% with positive, 68% with suspicious, 70% with negative CE findings). There was no statistically significant difference in diagnostic work-up, treatment, and symptom resolution between patients with positive, suspicious, and negative findings. Patients with obscure overt GI bleeding were less likely to have further diagnostic work-up (P = 0.001), and had the highest rate of symptom resolution as compared to other indications (P < 0.001).
Conclusions:
There is no significant difference in outcomes amongst patients with positive, suspicious, and negative CE findings. Patients with obscure overt GI bleeding had more favorable outcomes as compared to other indications.
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