Small Bowel Capsule Endoscopy Performance in Octogenarians: A Case-Control Study

Girelli, C.M.; Maiero, Stefania; Porta, P.; Cannizzaro, Renato

doi:10.1093/gerona/glq186

Cited by 18 publications

(23 citation statements)

References 43 publications

(33 reference statements)

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“…Because battery life is limited, incomplete examination of small bowel and colon could easily occur (12.08% and 19.19%, respectively). In this meta-analysis, age was an independent predictor affected small bowel incomplete examination rate, which is similar with the previous study of Girelli et al [48]. Small bowel incomplete examination rate declined over the past two decades, which may contributed by various investigations, such as prolonged battery life span in newer capsule generation [49,50] or reduced gastric transit time (GTT).…”

Section: Discussionsupporting

confidence: 88%

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Adverse Events of Video Capsule Endoscopy Over the Past Two Decades: A Systematic Review and Meta-Analysis

Wang

Pan

Liu

et al. 2020

Preprint

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Background: A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades. Methods: Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using random-effects model. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses. Results: In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI], 0.59%-0.89%), 0.75% (95% CI, 0.43%-1.13%), 0.00% (95% CI, 0.00%-0.00%), 0.94% (95% CI, 0.65%-1.28%), 0.67% (95% CI, 0.32%-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (-0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001).Conclusions: VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).

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Section: Discussionsupporting

confidence: 88%

“…Aging, neurological or swallowing disorder and patients with a weak or absent cough are high risk for VCE aspiration [63]. Fortunately, the patients included in this meta-analysis had no respiratory distress, and the problem can resolved quickly by spontaneously coughing [23,25,48,64].…”

Section: Discussionmentioning

confidence: 99%

Adverse Events of Video Capsule Endoscopy Over the Past Two Decades: A Systematic Review and Meta-Analysis

Wang

Pan

Liu

et al. 2020

Preprint

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“…A computed tomography (CT) colonography (virtual colonoscopy) does not involve an endoscope, but requires bowel preparation. [59][60][61][62] Hence, a capsule endoscopy should only be carried out in selected cases of older patients. 26 Older patients with unexplained IDA after a routine upper and lower gastrointestinal endoscopy have a favorable outcome.…”

Section: Additional Investigations and Etiologymentioning

confidence: 99%

“…A substantial number of patients found the capsule endoscopy study very tiresome and difficult; the diagnostic yield in older patients with IDA varies between 53% and 72%, but the related therapeutic options are mostly limited. [59][60][61][62] Hence, a capsule endoscopy should only be carried out in selected cases of older patients. The figure shows the flow chart for gastrointestinal investigation of older patients with IDA in University Hospitals Leuven, Leuven, Belgium ( Fig.…”

Section: Additional Investigations and Etiologymentioning

confidence: 99%

Iron deficiency anemia in older adults: A review

Joosten

2017

Geriatrics Gerontology Int

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Anemia in older adults is a risk factor for numerous negative outcomes. There is no standard definition, but in most studies, anemia is defined as a hemoglobin value <12 g/dL for women and <13 g/dL for men. Absolute iron deficiency anemia is defined as the combination of anemia and the absence of total body iron. Serum ferritin is the most frequently used diagnostic parameter, but its concentration increases with age and in the presence of inflammatory diseases. Other laboratory tests, such as transferrin saturation, soluble transferrin receptor and the soluble transferrin receptor/ferritin index might provide useful information, but there is a wide variety in the cut-off values and interpretation of the results. Recent research regarding hepcidin as a central regulator of iron homeostasis is promising, but it has not been used yet for the routine diagnosis of iron deficiency anemia. In older iron deficiency anemia patients, an esophagogastroduodenoscopy and colonoscopy should be initiated in order to identify the underlying bleeding cause. CT colonography can replace a colonoscopy, and in specific cases, a video capsule is recommended. It remains crucial to keep in mind which potential benefits might be expected from these investigations in this vulnerable population, taking into account the comorbidity and life expectancy, and one should discuss in advance the possible therapeutic options and complications with the patient, a family member or a proxy. Oral iron administration is the standard treatment, but parenteral iron is a convenient and safe way to provide the total iron dose in one or a few sessions. Geriatr Gerontol Int 2018; 18: 373-379.

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“…Aging, neurological or swallowing disorder and patients with a weak or absent cough are high risk for VCE aspiration [68]. Fortunately, the patients included in this meta-analysis had no respiratory distress, and the problem can resolved quickly by spontaneously coughing [23,25,53,69].…”

Section: Discussionmentioning

confidence: 99%

Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis

Wang

Pan

Liu

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: A full spectrum of video capsule endoscopy (VCE) adverse events over the past two decades has not been evaluated. We aimed to determine pooled rates, predictors and temporal-trend of VCE adverse events over the past two decades. Methods: Systematic search of PubMed and EMBASE for English-language publications reporting VCE adverse events (January 1, 2000 to March 31, 2019). Data were extracted independently by two investigators. Pooled VCE adverse event rates were calculated using the random or fixed model as appropriate. Predictors and temporal-trend of each adverse event were performed by meta-regression analyses. Results: In total, 402 studies were identified, including 108,079 VCE procedures. Rate of retention, swallow disorder, aspiration, technical failure, and procedural adverse events were 0.73% (95% confidence interval [CI], 0.59%-0.89%), 0.75% (95% CI, 0.43%-1.13%), 0.00% (95% CI, 0.00%-0.00%), 0.94% (95% CI, 0.65%-1.28%), 0.67% (95% CI, 0.32%-1.10%), respectively; incomplete examination rate of esophagus, stomach, small bowel, and colon were 9.05%, 7.69%, 12.08%, 19.19%, respectively. Patency capsule reduced retention rate by 5.04%, whereas known inflammatory bowel disease increased retention rate by 4.29%. Elder was the risk and protective factor for small bowel incomplete examination (0.30%) and swallow disorder (-0.72%), respectively. Rates of retention and small bowel incomplete examination significantly declined over time (P = .0006 and P < .0001).Conclusions: VCE adverse event rates were generally low, and retention and small bowel incomplete examination rates declined over the past two decades. Patients with known inflammatory bowel disease or elder should be alerted to high risk of retention or small bowel incomplete examination (PROSPERO: CRD42019139595).

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Small Bowel Capsule Endoscopy Performance in Octogenarians: A Case-Control Study

Abstract: In octogenarians, small bowel capsule endoscopy may be troublesome for capsule failure in reaching the duodenum. However, the diagnostic yield of small bowel capsule endoscopy and the rate of clinically significant lesions are high.

Cited by 18 publications

References 43 publications

Adverse Events of Video Capsule Endoscopy Over the Past Two Decades: A Systematic Review and Meta-Analysis

Adverse Events of Video Capsule Endoscopy Over the Past Two Decades: A Systematic Review and Meta-Analysis

Iron deficiency anemia in older adults: A review

Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis

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