TY - JOUR
T1 - Predictive Model for Positive Video Capsule Endoscopy in Iron Deficiency Anemia
AU - Hamdeh, Shadi
AU - Fathallah, Jihan
AU - Zhang, Hui
AU - Charoen, Amber
AU - Altamimi, Barakat Aburajab
AU - Odufalu, Florence Damilola
AU - Dave, Devashree
AU - Sayed, Amer El
AU - Glick, Laura R.
AU - Grisolano, Scott
AU - Hachem, Christine
AU - Hammami, Muhammad Bader
AU - Mahmoud, Khaldoun Haj
AU - Levy, Alexander N.
AU - Rao, Vijaya L.
AU - Shim, Hong Gi
AU - Semrad, Carol
AU - Olyaee, Mojtaba
AU - Micic, Dejan
N1 - Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/7
Y1 - 2023/7
N2 - Background and Aims: Bleeding from the gastrointestinal tract can contribute to the development of iron deficiency anemia (IDA) among individuals without another obvious source of bleeding. In order to identify patients most likely to benefit from examination of the small bowel, our aim was to create a risk score for positive video capsule endoscopy (VCE) in IDA utilizing a multicenter collection of studies. Methods: We performed a retrospective multicenter study utilizing VCE studies performed for an indication of IDA between 1/1/2005 and 7/31/2018. VCE findings were graded based on the P0–P2 grading system. The primary outcome of interest was a positive (P2) VCE. Data were analyzed with Student’s t test for continuous variables and the Fisher’s exact test for categorical variables. Logistic regression was used to identify independent associations with positive VCE. Results: In total, 765 VCE procedures were included with 355 (46.5%) male subjects and a median age of 63.2 (SD 15.3) years. One hundred ninety studies (24.8%) were positive (P2) for small bowel bleeding. Four variables associated with positive VCE which were incorporated into a point scoring system: (+) 1 for age ≥ 66 years, active smoking and cardiac arrythmia and (−) 1 for preceding hemoglobin level ≥ 8.5. The risk probabilities for positive VCE-assigned scores − 1, 0, 1, and 2 + were 12.3% (95% CI 7.3–17.3%), 20% (14.9–25.1%), 34.8% (28.6–41%), and 39% (30–47.8%). Conclusion: In order to improve the diagnostic yield of capsule examinations, risk factors should be applied to clinical decision-making. We created a risk score for positive VCE in IDA, including the risk factors of age, smoking, history of cardiac arrythmia, and preceding hemoglobin level.
AB - Background and Aims: Bleeding from the gastrointestinal tract can contribute to the development of iron deficiency anemia (IDA) among individuals without another obvious source of bleeding. In order to identify patients most likely to benefit from examination of the small bowel, our aim was to create a risk score for positive video capsule endoscopy (VCE) in IDA utilizing a multicenter collection of studies. Methods: We performed a retrospective multicenter study utilizing VCE studies performed for an indication of IDA between 1/1/2005 and 7/31/2018. VCE findings were graded based on the P0–P2 grading system. The primary outcome of interest was a positive (P2) VCE. Data were analyzed with Student’s t test for continuous variables and the Fisher’s exact test for categorical variables. Logistic regression was used to identify independent associations with positive VCE. Results: In total, 765 VCE procedures were included with 355 (46.5%) male subjects and a median age of 63.2 (SD 15.3) years. One hundred ninety studies (24.8%) were positive (P2) for small bowel bleeding. Four variables associated with positive VCE which were incorporated into a point scoring system: (+) 1 for age ≥ 66 years, active smoking and cardiac arrythmia and (−) 1 for preceding hemoglobin level ≥ 8.5. The risk probabilities for positive VCE-assigned scores − 1, 0, 1, and 2 + were 12.3% (95% CI 7.3–17.3%), 20% (14.9–25.1%), 34.8% (28.6–41%), and 39% (30–47.8%). Conclusion: In order to improve the diagnostic yield of capsule examinations, risk factors should be applied to clinical decision-making. We created a risk score for positive VCE in IDA, including the risk factors of age, smoking, history of cardiac arrythmia, and preceding hemoglobin level.
KW - Gastrointestinal bleeding
KW - Iron deficiency anemia
KW - Small bowel bleeding
KW - Video capsule endoscopy
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U2 - 10.1007/s10620-023-07918-0
DO - 10.1007/s10620-023-07918-0
M3 - Article
C2 - 36917313
AN - SCOPUS:85149891634
SN - 0163-2116
VL - 68
SP - 3083
EP - 3091
JO - Digestive diseases and sciences
JF - Digestive diseases and sciences
IS - 7
ER -