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The impact of hospitalization on the performance of capsule endoscopy (CE)
Heinz Albrecht1, Marcel Vetter1, Wolfgang Dauth2
1Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Insights
In-patients undergoing capsule endoscopy (CE) are more likely to have incomplete examinations, potentially missing critical findings in the ileum. Special attention is needed to ensure complete CE for hospitalized patients.
Area of Science:
- Gastroenterology
- Medical Imaging
- Diagnostic Endoscopy
Background:
- Complete capsule endoscopy (CE) is crucial for accurate patient evaluation.
- Incomplete examinations can lead to missed diagnoses and suboptimal patient care.
Purpose of the Study:
- To identify risk factors associated with incomplete capsule endoscopy (CE).
- To specifically investigate the impact of patient hospitalization on CE completeness.
Main Methods:
- Retrospective analysis of 161 patients undergoing CE between 2013 and 2016.
- Evaluation of indications including active bleeding, iron deficiency anemia (IDA), inflammatory bowel disease (IBD), abdominal pain, and familial adenomatous polyposis (FAP).
- Comparison of examination completeness and small bowel transit time (SBTT) between in-patients and out-patients.
Main Results:
- In-patients had a significantly higher rate of incomplete CE (8.7%) compared to out-patients (1.8%), primarily due to battery depletion.
- Familial adenomatous polyposis (FAP) patients, all out-patients, exhibited the longest SBTT.
- Pathologic lesions, including major findings like ulcers and angiodysplasia, were identified in the terminal ileum in 43 patients, highlighting the importance of complete examination.
Conclusions:
- In-patients represent a higher-risk group for incomplete capsule endoscopy (CE).
- Special protocols may be necessary to ensure complete CE in hospitalized patients.
- Completeness of CE is vital for detecting pathologies located in the ileum.
Background:
For proper evaluation of capsule endoscopy (CE), a complete examination is necessary.
Aim:
We evaluated risk factors of an incomplete CE with focus on patient hospitalization.
Methods:
We retrospectively evaluated 161 consecutive patients who underwent CE between 01.07.2013 and 13.03.2016. Main indications were active bleeding, iron deficiency anemia (IDA), inflammatory bowel disease (IBD), abdominal pain, and familial adenomatous polyposis (FAP).
Results:
We report the results of 103 in-patients and 56 out-patients. Eighty-two patients were male, average age was 58.9 years (range 18-90). Indications for CE were active bleeding (103 patients), IDA and IBD (16 patients), and FAP, abdominal pain and others (eight examinations each). All FAP patients were out-patients, but showed the longest small bowel transit time (SBTT) of 443.6min (p=0.0001). The shortest SBTT was found in out-patients without FAP (267.5min, p<0.05). In the in-patient group, nine endoscopies did not record the entire small bowel (8.7%) due to battery depletion, compared with only one incomplete examination in the out-patients (1.8%, p=0.036). We found pathologic lesions in the last 30min of the SBTT in 43 patients, and this indicates the necessity for complete examination. Thirteen of these 43 patients showed major lesions such as ulcers or angiodysplasia in this last region alone.
Conclusion:
In-patients might require special treatment to ensure complete examination, since a considerable amount of pathologies can only be found in the ileum.
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