The Use of Capsule Endoscopy For Diagnosis of Iron Deficiency Anemia: A Retrospective Analysis
Autor: | James Stone, Kanika Grover, Charles N. Bernstein |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Capsule Endoscopy law.invention 03 medical and health sciences 0302 clinical medicine Capsule endoscopy law Internal medicine Ectasia Odds Ratio medicine Humans Retrospective Studies Anemia Iron-Deficiency biology business.industry Gastroenterology Middle Aged medicine.disease Occult Confidence interval Ferritin Iron-deficiency anemia 030220 oncology & carcinogenesis Relative risk biology.protein 030211 gastroenterology & hepatology Gastrointestinal Hemorrhage business |
Zdroj: | Journal of Clinical Gastroenterology. 54:452-458 |
ISSN: | 0192-0790 |
Popis: | Background There was some ambiguity in the recent guidelines on the use of capsule endoscopy (CE) in cases of iron deficiency anemia (IDA). Goal We aimed to examine the yield of CE in diagnosing the cause of IDA and to define clinical parameters that predict higher diagnostic yields. Materials and methods A total of 1351 individuals underwent CE in Winnipeg between 2005 and 2016. All studies were reported by 1 reading physician. Data included demographics and requested information on medication use, prior imaging studies, and hemoglobin and ferritin levels. In a total of 620 (46%) patients, CE was indicated for occult gastrointestinal bleeding or IDA. Positive findings on CE were separated into "definite" and "possible." Multinomial regression analysis was used to determine the variables correlated with definite CE findings. A survey analysis was then used to assess how the study results impacted further management. Results With regard to the 620 patients, the mean age was 62.9 years, mean hemoglobin level was 89 g/L, and median ferritin level was 9 μg/L. A total of 210 (33.9%) patients had positive findings (definite: 23%, possible: 10.8%). Vascular ectasias were the majority of definite findings (47.5%). Predictors of definite findings were age (relative risk ratio: 1.04; 95% confidence interval: 1.02-1.06) and male sex (relative risk ratio: 1.88; 95% confidence interval: 1.25-2.83). An overall 12.7% of positive studies required therapeutic intervention, with 65.8% undergoing further workup. Conclusion We report a 33.9% positive yield, with 65.8% of patients undergoing further workup as a result of CE and 12.7% requiring therapeutic intervention. We conclude that CE plays an important role in the investigation of IDA and occult gastrointestinal bleeding and has important implications on further management. |
Databáze: | OpenAIRE |
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