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The role of early video capsule endoscopy in the diagnosis and prognosis of obscure gastrointestinal bleeding: A multi‐center propensity score matching study
Author(s) -
Zhao Ran,
Nakamura Masanao,
Wu Shan,
Uchida Genta,
Yamamura Takeshi,
Gao YunJie,
Goto Hidemi,
Fujishiro Mitsuhiro,
Ge ZhiZheng
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15491
Subject(s) - medicine , odds ratio , confidence interval , propensity score matching , capsule endoscopy , obscure gastrointestinal bleeding , incidence (geometry) , gastroenterology , univariate analysis , endoscopy , multivariate analysis , physics , optics
Background and Aim Video capsule endoscopy (VCE) is a first‐line procedure for the diagnosis of obscure gastrointestinal bleeding (OGIB). The opinions on the timing for such diagnostic evaluation remain unclear. We aimed to explore the role of early VCE in OGIB patients. Methods A total of 997 patients that underwent VCE at Renji Hospital and Nagoya University from May 15, 2002, to December 28, 2016, were included in this study. We matched patients that underwent early VCE within 14 days of bleeding (early group, n = 678) to patients that did not (late group, n = 319) via 1:1 propensity score matching (PSM). We then compared VCE diagnostic rates and the prevalence of post‐VCE rebleeding in patients with initial negative VCE findings within 1 year between these groups before and after PSM. Results Following PSM, early VCE was associated with a significantly higher rate of OGIB diagnosis (56.4% vs 45.5%, P = 0.001) and with a significantly lower incidence of rebleeding within 1 year following treatment (24.7% vs 36.7%, P = 0.041). In univariate and multivariate analyses, VCE timing (odds ratio 0.648; 95% confidence interval 0.496–0.847, P = 0.001 and odds ratio 0.666; 95% confidence interval 0.496–0.894, P = 0.007, respectively) was found to be linked with a higher rate of positive findings. Conclusion Early VCE can improve the reliability of OGIB diagnosis while also reducing rates of post‐VCE rebleeding. This suggests that timely and accurate diagnosis can help to improve OGIB patient treatment and prognosis.