Long-term outcome in patients with obscure gastrointestinal bleeding after negative capsule endoscopy

Table 1 Clinical characteristics of patients with obscure gastrointestinal bleeding n (%)

Characteristics	Total (n = 95)
Age (yr), median (range)	61.0 (17-85)
Male	62 (65.3)
Obscure-overt bleeding	73 (76.8)
Complete small-bowel visualization	77 (81.1)
Comorbidity	43 (45.3)
Hemoglobin concentration at the time of the procedure (g/dL), mean ± SD	8.3 ± 2.0
Need for transfusion before capsule endoscopy	50 (52.6)
Diagnostic yield	38 (40.0)
Follow-up duration (mo), median (range)	23.7 (6.0-89.4)
> 12 mo follow-up	73 (76.8)
Aspirin use	23 (24.2)
Other antiplatelet agent	13 (13.7)
Anticoagulation	8 (8.4)
Nonsteroidal anti-inflammatory drugs	10 (10.5)

Table 2 Capsule endoscopy results of patients with obscure gastrointestinal bleeding and rebleeding rates n (%)

Findings	Total (n = 95)	Specific treatment	Rebleeding
P2 lesion	38	24 (63.2)	14 (36.8)
Ulcer or erosion	8	6 (75.0)	3 (37.5)
Tumor	2	2 (100)	0 (0)
Angiodysplasia	10	3 (30.0)	4 (40.0)
Bleeding from unknown focus	9	4 (44.4)	4 (44.4)
IBD including tuberculosis enteritis	9	9 (100)	3 (33.3)
P1 lesion	6	0 (0)	1 (16.7)
Erosion	2	0 (0)	1 (50.0)
Non-bleeding polyp	2	0 (0)	0 (0)
Lymphangiectasia	2	0 (0)	0 (0)
P0 lesion	51	3 (5.9)	12 (23.5)
Total	95	27 (28.4)	27 (28.4)

IBD: Inflammatory bowel disease.

Table 3 Risk factors for rebleeding in patients with obscure gastrointestinal bleeding

Variables	Hazard ratio	95%CI	P value
Male	2.082	0.882-4.910	0.094
Age > 50 yr	0.980	0.328-2.922	0.971
Hb < 8 g/dL	0.861	0.365-2.029	0.732
Transfusion before CE	1.719	0.674-4.382	0.257
Comorbidity	1.619	0.661-3.969	0.292
Aspirin use	1.020	0.357-2.914	0.970
Anticoagulation use	5.019	1.560-16.145	0.007
NSAIDs use	1.153	0.314-4.232	0.830
Obscure-overt bleeding	1.143	0.382-3.416	0.811
Specific treatment	1.123	0.368-3.422	0.839
Positive CE	1.564	0.561-4.355	0.392

NSAIDs: Nonsteroidal anti-inflammatory drugs; CE: Capsule endoscopy.

Table 4 Follow-up duration and rebleeding rates in patients with obscure gastrointestinal bleeding after negative capsule endoscopy

Study	No. of enrolled cases	Follow-up duration (mo)	Rebleeding rates after negative capsule endoscopy
Lai et al[9]	49	12	6%
Macdonald et al[10]	49	17	11%
Park et al[11]	51	32	36%
Delvaux et al[19]	44	12	0%
Lorenceau-Savale et al[21]	35	12	0%
Current study	51	23	23%