Capsule Endoscopy in Elderly Patients with Obscure Gastrointestinal Bleeding: Retrospective Analysis of 152 Cases

Abstract

Background: Capsule endoscopy (CE) is a highly sensitive examination for the detection of small bowel lesions. However, there are few clinical studies on obscure gastrointestinal bleeding (OGIB) among elderly patients. This study reports the risk factors of angiodysplasia with CE in the elderly. Methods: To ascertain the predictive clinical associations for angiodysplastic lesions as a cause of OGIB in the elderly, we retrospectively analyzed CE results in consecutive cases over a period of 4 years and 9 months (March 2004 to November 2008). Data were collected regarding patient demographics and potential risk factors. Risk factors were analyzed by the χ2 test and binary logistic regression analyses. Results: From March 2004 to November 2008, a total of 121 consecutive patients (71 male and 50 female; mean age and standard deviation, 57.9 ± 17.9 years) were referred to our department for CE evaluation of OGIB. All cases had undergone standard investigation with negative results within the 3 months prior to CE. Angiodysplastic lesions of the small bowel, the most common cause of OGIB in the elderly, were found in 52% of cases. Clinical associations with angiodysplastic lesions as a cause of OGIB were examined. One risk factor was increased age (≥ 65 years) (odds ratio, 2.76; 95% confidence interval, 1.20–6.35; p = 0.02). Conclusion: The use of CE in the elderly is a simple and safe diagnostic tool in the evaluation of OGIB. CE affords great precision while avoiding radiation, and should thus be the preferred method of investigation in this population.

Keywords

• angiodysplasia
• capsule endoscopy
• elderly
• obscure gastrointestinal bleeding
• small bowel