Abstract
the aim of this study was to determine predictive factors for an incomplete capsule endoscopy and an inadequate small-bowel preparation in capsule endoscopy. predictive factors for an incomplete capsule endoscopy were evaluated. Therefore, all patients with incomplete examinations performed between June 2009 and February 2016 were retrospectively included and compared with all patients with complete procedures performed between January 2014 and February 2016. Predictive factors of an inadequate small-bowel cleanliness were assessed. Therefore, the subset of patients that underwent capsule endoscopy between January 2014 and February 2016, including incomplete examinations, were evaluated. Small-bowel cleanliness was evaluated according to a quantitative index and a qualitative evaluation scale. Data with regard to patient and capsule endoscopy was analyzed. 31 incomplete and 122 complete capsule endoscopies were included in the analysis of predictive factors for an incomplete capsule endoscopy. The degree of dependency (OR = 4.67; p = 0.028), performance of a capsule endoscopy in hospitalized patients (OR = 4.04; p = 0.006) and prior abdominal surgery (OR = 3.45; p = 0.012) were independent predictive factors of an incomplete procedure. 130 patients were included in the analysis of predictive factors for an inadequate small-bowel cleanliness. The mean quantitative index value was 7.3 (s.d. ± 2.3); 41.6% and 58.5% of capsule endoscopies were classified as poor-fair and good/excellent respectively, according to the qualitative evaluation. Independent predictive factors for an inadequate preparation according to the quantitative index included male gender (Beta = -0.79; p = 0.028), small-bowel transit time (Beta = -0.007; p < 0.0001) and cardiac disease (Beta = -1.29; p = 0.001). Associated factors according to the qualitative evaluation included male gender (OR = 0.406; p = 0.027) and small-bowel transit time (SBTT) (OR = 0.993; p < 0.0001). inpatient status, higher degrees of dependency and abdominal surgery are predictive factors for an incomplete capsule endoscopy; male gender and higher small-bowel transit time are predictive factors for an inadequate cleanliness.
Highlights
Since its introduction in 2001, capsule endoscopy (CE) has revolutionized small bowel imaging as it represents a reliable, safe and noninvasive diagnostic method for the assessment of the entire small-intestinal mucosa [1,2,3,4,5,6,7]
Associated factors according to the qualitative evaluation included male gender (OR = 0.406; p = 0.027) and small-bowel transit time (SBTT) (OR = 0.993; p < 0.0001)
CE has a significantly higher diagnostic yield compared to other methods including push enteroscopy, enteroclysis, computed tomography, magnetic resonance imaging and angiography [3,4,5,8,9,10,11,12].CE currently plays an important role in a wide range of clinical indications, including obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia, known or suspected small-bowel Crohn’s disease, small-bowel tumors, polyposis syndromes and celiac disease [1,2,3,8,10,12,13,14,15,16]
Summary
Since its introduction in 2001, capsule endoscopy (CE) has revolutionized small bowel imaging as it represents a reliable, safe and noninvasive diagnostic method for the assessment of the entire small-intestinal mucosa [1,2,3,4,5,6,7]. The diagnostic yield of CE may be hampered by two main factors, an incomplete examination of the entire small-bowel during the recording time of the device and an inadequate enteric cleanliness [2,5,6,11,13,14,15,18,19,20,21].it is essential to recognize factors that contribute to Author contributions: Ana Ponte designed the study, performed the research, analyzed the data and wrote the manuscript. Rolando Pinho designed the study, performed the research, analyzed the data and wrote the manuscript. Adélia Rodrigues performed the research and analyzed the data. Jaime Rodrigues performed the research and analyzed the data. João Carvalho performed the research and analyzed the data
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