Predictors of double balloon endoscopy outcomes in the evaluation of gastrointestinal bleeding

Table 1 Double balloon endoscopy findings

Findings	n (%)
AVM	20 (36.4)
Ulcer	3 (5.5)
Ulcerated polyp	3 (5.5)
Ulcerated mass	1 (1.8)
Multiple erosions	2 (3.6)
Portal HTN enteropathy	1 (1.8)
Vascular polyp	1 (1.8)
Negative findings	24 (43.6)

AVM: Arteriovenous malformation.

Table 2 Bivariate analysis of negative diagnostic double balloon endoscopy

Variables	Negative diagnostic yield	No therapeutic intervention
Pre-DBE ASA score ≤ 2	0.611	0.044
GI bleed within 1 wk prior to DBE	0.179	0.010
Blood transfusions ≤ 4 units 10 yr prior to DBE	0.149	0.027
> 1 DBE in one day by single endoscopist	0.016	0.024
Hgb > 9 mg/dL in the week prior to DBE	0.010	0.035
No blood transfusions in the year prior to DBE	0.019	0.044
Prior EGD with no ulcers or AVMs	0.031	0.004
Prior EGD or colonoscopy with no ulcers or AVMs	0.001	0.001
Prior enteroscopy with no AVMs	0.013	0.009

DBE: Double balloon endoscopy; GI: Gastrointestinal; EGD: Esophagogastroduodenoscopy; AVM: Arteriovenous malformation.

Table 3 Time between gastrointestinal bleed, video capsule endoscopy and double balloon endoscopy in relation to outcomes n (%)

Variables		Less than 1 wk	1 wk to 1 mo	1 mo to 1 yr	More than 1 yr
Time from onset of GI bleed to VCE	VCE with positive findings/total No. of VCE	10/10	2/3	11/14	15/18
		(100)	(66.7)	(78.6)	(83.3)
Time from onset of GI bleed to DBE	DBE with positive findings/total No. of DBE	2/8	3/3	9/14	17/27
		(25)	(100)	(64.3)	(63)
	DBE leading to therapy/total No. of DBE	1/8	3/3	7/14	14/27
		(12.5)	(100)	(50)	(51.9)
Time from VCE to the DBE procedure	DBEs with positive diagnostic yield/total No. of DBEs	8/15	3/6	15/25	3/6
		(53.3)	(50)	(60)	(50)
	DBEs that led to therapy/total No. of DBEs	7/15	2/6	13/25	2/6
		(46.7)	(33.3)	(52.0)	(33.3)

VCE: Video capsule endoscopy; DBE: Double balloon endoscopy; GI: Gastrointestinal.

Table 4 Multivariate logistic regression of factors associated with negative diagnostic yield of double balloon endoscopy

Variables	OR (95%CI)	P value
> 1 DBE in one day by single endoscopist	16.63 (2.04-135.45)	0.009
No blood transfusions within year prior to DBE	13.04 (1.53-111.04)	0.019
Prior EGD or colonoscopy with no ulcers or AVMs	19.30 (1.26-295.18)	0.033

DBE: Double balloon endoscopy; EGD: Esophagogastroduodenoscopy; AVM: Arteriovenous malformation.

Table 5 Multivariate logistic regression of factors associated with non-therapeutic double balloon endoscopy

	OR (95%CI)	P value
> 1 DBE in one day by single endoscopist	18.28 (2.24 -148.86)	0.007
GI bleed within 1 wk prior to DBE	10.77 (2.18–53.14)	0.004
Blood transfusions ≤ 4 units in the year prior to DBE	4.27 (1.03-17.71)	0.045
Prior EGD or colonoscopy with no ulcers or AVMs	8.47 (1.28-55.87)	0.027

DBE: Double balloon endoscopy; GI: Gastrointestinal; EGD: Esophagogastroduodenoscopy; AVM: Arteriovenous malformation.