Suspected Small Bowel Bleeding: A Single-Center Retrospective Study on Long-Term Prognosis and Predictive Factors

Area of Science:

• Gastroenterology
• Internal Medicine
• Oncology

Background:

• Suspected small bowel bleeding (SSBB) presents diagnostic challenges, often remaining unexplained despite standard endoscopic procedures.
• Identifying prognostic factors is crucial for managing SSBB patients and improving outcomes.

Purpose of the Study:

• To identify prognostic factors for mortality in patients with SSBB.
• To evaluate the impact of severe anemia and other clinical factors on patient survival after SSBB diagnosis.

Main Methods:

• Retrospective observational study of patients aged ≥20 years with SSBB undergoing capsule endoscopy (CE).
• Data collected included patient characteristics, transfusion history, CE findings, blood tests, and mortality events.
• Multivariate analysis was used to identify independent prognostic factors.

Main Results:

• Capsule endoscopy identified bleeding sources in 40.4% of 99 SSBB patients.
• Mortality occurred in 34 cases over a median follow-up of 35 months, with a 3-year survival rate of 71.1%.
• Hemoglobin levels <8.0 g/dL and end-stage cancer were independent predictors of mortality. Hemoglobin <8.0 g/dL remained a predictor even after excluding cancer patients.

Conclusions:

• Hemoglobin levels <8.0 g/dL are a significant independent predictor of mortality in patients with SSBB.
• Anemia severity is a critical factor influencing survival in SSBB patients.
• These findings underscore the need for close monitoring and management of anemia in SSBB cases.