Brief Article
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World J Gastroenterol. Nov 14, 2010; 16(42): 5329-5333
Published online Nov 14, 2010. doi: 10.3748/wjg.v16.i42.5329
Factors associated with incomplete small bowel capsule endoscopy studies
Mitchell M Lee, Andrew Jacques, Eric Lam, Ricky Kwok, Pardis Lakzadeh, Ajit Sandhar, Brandon Segal, Sigrid Svarta, Joanna Law, Robert Enns
Mitchell M Lee, Andrew Jacques, Eric Lam, Ricky Kwok, Pardis Lakzadeh, Ajit Sandhar, Brandon Segal, Sigrid Svarta, Joanna Law, Robert Enns, St Paul’s Hospital, University of British Columbia, 770-1190 Hornby Street, Vancouver, British Columbia V6Z 2K5, Canada
Author contributions: Lee MM reviewed the literature and wrote/edited the manuscript; Jacques A, Kwok R, Lakzadeh P, Sandhar A, Segal B and Svarta S performed the data collection, interpretation and analysis; Lam E performed statistical analysis on the data set and edited the manuscript; Law J and Enns R designed the study and edited the manuscript.
Supported by St. Paul’s Hospital Division of Gastroenterology and Pacific Gastroenterology Associates, Vancouver, British Columbia, Canada
Correspondence to: Dr. Robert Enns, St Paul’s Hospital, University of British Columbia, 770-1190 Hornby Street, Vancouver, British Columbia V6Z 2K5, Canada. renns@interchange.ubc.ca
Telephone: +1-604-6886332 Fax: +1-604-6892004
Received: May 26, 2010
Revised: June 20, 2010
Accepted: June 27, 2010
Published online: November 14, 2010
Abstract

AIM: To identify patient risk factors associated with incomplete small bowel capsule endoscopy (CE) studies.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

Keywords: Capsule, Capsule endoscopy, Incomplete endoscopy