[Show abstract][Hide abstract] ABSTRACT: To identify patient risk factors associated with incomplete small bowel capsule endoscopy (CE) studies.
Data from all CE procedures performed at St. Paul's Hospital in Vancouver, British Columbia, Canada, between December 2001 and June 2008 were collected and analyzed on a retrospective basis. Data collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure, hospitalization, diabetes mellitus with or without end organ damage, limitations in mobility, renal insufficiency, past history of bowel obstruction, abdominal surgery, abdominal radiation therapy and opiate use. Risk factors were analyzed using a univariable and multivariable logistic regression model.
From a total of 535 CE procedures performed, 158 were incomplete (29.5%). The univariable analysis showed that CE procedures performed for overt gastrointestinal bleeding (P = 0.002), and for patients with a prior history of abdominal surgery (P = 0.023) or bowel obstruction (P = 0.023) were significantly associated with incomplete CE studies. Patients on opiate medications (P = 0.094) as well as hospitalized patients (P = 0.054) were not statistically significant, but did show a trend towards incomplete CE. The multivariable analysis showed that independent risk factors for an incomplete CE procedure include prior history of bowel obstruction [odds ratios (OR) 2.77, P = 0.02, 95% confidence intervals (CI): 1.17-6.56] and procedures performed for gastrointestinal bleeding (Occult OR 2.04, P = 0.037, 95% CI: 1.04-4.02 and Overt OR 2.69, P = 0.002, 95% CI: 1.44-5.05). Patients with a prior history of abdominal surgery (OR 1.46, P = 0.068, 95% CI: 0.97-2.19), those taking opiate medications (OR 1.54, P = 0.15, 95% CI: 0.86-2.76) and hospitalized patients (OR 1.82, P = 0.124, 95% CI: 0.85-3.93) showed a trend towards statistical significance.
We have identified a number of risk factors for incomplete CE procedures that can be used to risk-stratify patients and guide interventions to improve completion rates.
Preview · Article · Nov 2010 · World Journal of Gastroenterology
[Show abstract][Hide abstract] ABSTRACT: Narrow Band Imaging (NBI), developed by Olympus Medical Systems (Olympus, Japan), is a new and well-recognized advance in endoscopic imaging. Although conventional white-light endoscopy uses the entire spectrum of visible light (400 nm to 700 nm) to examine tissue, the NBI system uses optic filters to isolate two specific bands of light: 415 nm blue and 540 nm green (1-4). By isolating these two bands of light and taking into account their absorptive and reflective properties on the mucosal surface, an image that enhances visualization of superficial mucosal and vascular structures is created. The highlight of NBI endoscopy is the proposed ability to predict pathology in real-time based on the mucosal and vascular changes detected. NBI has been investigated for use as a diagnostic modality in a variety of lesions in the gastrointestinal, respiratory and genitourinary tract (4-6). Conveniently, the NBI mode on an endoscope can be activated with the depression of a switch similar to taking a picture.
Preview · Article · Mar 2009 · Canadian journal of gastroenterology = Journal canadien de gastroenterologie