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Long‐term outcome in patients with obscure gastrointestinal bleeding after capsule endoscopy
Author(s) -
Tan Wei,
Ge Zhi Zheng,
Gao Yun Jie,
Li Xiao Bo,
Dai Jun,
Fu Seng Wang,
Zhang Yao,
Xue Han Bing,
Zhao Yun Jia
Publication year - 2015
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12222
Subject(s) - medicine , hazard ratio , capsule endoscopy , gastroenterology , confidence interval , univariate analysis , gastrointestinal bleeding , multivariate analysis , proportional hazards model
Objective This study aimed to identify the risk factors associated with rebleeding and long‐term outcomes after capsule endoscopy ( CE ) for obscure gastrointestinal bleeding ( OGIB ) in a follow‐up study. Methods Data of consecutive patients who underwent CE due to OGIB from J une 2002 to J anuary 2012 were retrospectively reviewed. The C ox proportional hazard model was used to evaluate the risk factors associated with rebleeding, while K aplan– M eier survival curves and the log–rank test were used to analyze cumulative rebleeding rates. Results The overall rebleeding rate after CE in patients with OGIB was 28.6% (97/339) during a median follow‐up of 48 months (range 12–112 months). Multivariate analysis showed that age ≥60 years (hazard ratio [ HR] 2.473, 95% confidence interval [ CI ] 1.576–3.881, P = 0.000), positive CE findings ( HR 3.393, 95% CI 1.931–5.963, P = 0.000), hemoglobin ≤70 g/L before CE ( HR 2.010, 95% CI 1.261–3.206, P = 0.003), nonspecific treatments ( HR 2.500, 95% CI 1.625–3.848, P = 0.000) and the use of anticoagulants, antiplatelet or non‐steroidal anti‐inflammatory drugs after CE ( HR 2.851, 95% CI 1.433–5.674, P = 0.003) were independent risk factors associated with rebleeding. Univariate analysis showed that chronic hepatitis was independently associated with rebleeding in CE ‐negative patients ( P = 0.021). Conclusions CE has a significant impact on the long‐term outcome of patients with OGIB . Further investigation and close follow‐up in patients with OGIB and those with negative CE findings are necessary.