Year 2022 / Volume 114 / Number 6
Original
Can we predict an incomplete capsule endoscopy? Results of a multivariate analysis using a logistic regression model

329-334

DOI: 10.17235/reed.2021.7320/2020

Elena Macías, Alfonso Elosua González, José Francisco Juanmartiñena, Ana Borda Martín, Inmaculada Elizalde, Ignacio Fernández-Urién,

Abstract
Background and aims: small bowel capsule endoscopy (SBCE) does not reach the cecum within the battery lifetime in approximately 15-35 % of patients. Incomplete examinations result in diagnostic delays and increase the economic burden. To date, risk factors for incomplete examinations have been described with contradictory results. The aims of this study were to analyze the rate and identify risk factors for incomplete examinations, excluding capsule retentions, in a large cohort of patients. Methods: data from 1,894 consecutive SBCE examinations performed from January 2009 to December 2015 were analyzed. Variables recorded included demographics, past medical and surgical history, biochemical parameters and procedure characteristics. The rate of incomplete examinations, excluding capsule retentions, was calculated and a multivariate analysis using a logistic regression model was performed in order to evaluate predictive factors. Results: the incidence of incomplete examinations, excluding capsule retentions, was 10.1 % (187 incomplete procedures). The multivariate analysis showed that age > 65 years, gastric transit time > 41 minutes and SB transit time > 286 minutes are predictive factors for incomplete examinations, increasing the probability of this event by 199 % (OR: 1.99; 95 % CI: 1.34-2.95), 260 % (OR: 2.60; 95 % CI: 1.72-3.93) and 352 % (OR: 3.52; 95 % CI: 2.26-5.48), respectively. Conclusions: age > 65 years, gastric transit time > 41 minutes and SB transit time > 286 minutes are predictive factors for incomplete examinations excluding capsule retentions. Both age and gastric transit time events are known before the procedure ends. Therefore, pharmacologic or endoscopic measures may be taken into account to avoid incomplete examinations.
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References
1. Iddan G, Meron G, Glukhovsky A, et al. “Wireless capsule endoscopy”. Nature 2000;405:417-418.
2. Ladas SD, Triantafyllou K, Spada C, et al. Society of Gastrointestinal Endoscopy (ESGE). Recommendations on use clinical of video capsule endoscopy to investigate small bowel, esophageal and colon diseases. Endoscopy 2010;42:220-227.
3. Cheung DY, Kim JS, Shim KN, et al. The Usefulness of Capsule Endoscopy for Small Bowel Tumors. Clin Endosc 2016;49:21-5.
4. Singeap AM, Stanciu C, Trifan A. Capsule endoscopy: The road ahead. World J Gastroenterol 2016;22:369-78.
5. Nowak T. A global perspective on capsule endoscopy. Ann Transl Med 2017;5:422.
6. Goran L, Negreanu AM, Stemate A, et al. Capsule endoscopy: Current status and role in Crohn's disease. World J Gastrointest Endosc 2018;10:184-192.
7. Triester SL, Leighton JA, Leontiadis GI, et al. A metanalysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol 2005;100:2407-2418.
8. Marmo R, Ttondano R, Piscopo, et al. Metanalysis capsule enteroscopy vs conventional modalities in diagnosis of small bowel diseases. Aliment Pharmacol Ther 2005;22:595-604.
9. Rondonotti E, Herrerias JM, Pennazio M, et al. Complications, limitations and failures of capsule endoscopy: a review of 733 cases. Gastrointest Endosc 2005;62:712-716.
10. Selby W. Complete small-bowel transit in patients undergoing capsule endoscopy: determining factors and improvement with metoclopramide. Gastrointest Endosc. 2005;61:80-5.
11. Rondonotti E, Villa F, Mulder CJ, et al. Small bowel capsule endoscopy in 2007: indications, risks and limitations. World J Gastroenterol. 2007;13:6140-9.
12. Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc 2009; 69:74-80.
13. Liao Z, Gao C, Xu C, et al. Indications and detection, completion and retention rates of small bowel capsule endoscopy: a systematic review. Gastrointest Endosc 2010;71:280-286.
14. Lee MM, Jacques A, Lam E, et al. Factors associated with incomplete small bowel capsule endoscopy studies. World J Gastroenterol. 2010;16:5329-33.
15. Höög CM, Bark LÅ, Arkani J, et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract. 2012;2012:518718.
16. Cotter J, de Castro FD, Magalhães J, et al. Finding the solution for incomplete small bowel capsule endoscopy. World J Gastrointest Endosc. 2013; 5:595-9.
17. Lim YJ, Lee OY, Jeen YT, et al. Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry. Clin Endosc. 2015; 48:399-404.
18. Chen HB, Huang Y, Chen SY, et al. Small bowel preparations for capsule endoscopy with manitol and simethicone: a prospective, randomized, clinical trial. J Clin Gastroenterol. 2011;45:337-41.
19. Ponte A, Pinho R, Rodrigues A, Silva J, Rodrigues J, Sousa M, Carvalho J. Predictive factors of an incomplete examination and inadequate small-bowel cleanliness during capsule endoscopy. Rev Esp Enferm Dig. 2018;110(10):605-611.
20. Höög CM, Bark LÅ, Arkani J, et al. Capsule retentions and incomplete capsule endoscopy examinations: an analysis of 2300 examinations. Gastroenterol Res Pract 2012;2012:518718.
21. Spada C, McNamara D, Despott EJ, et al. Performance measures for small-bowel endoscopy: a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. Endoscopy 2019;51(6):574-598.
22. Albrecht H, Vetter M, Dauth W, Zoicas F, Neurath MF, Hagel AF. The impact of hospitalization on the performance of capsule endoscopy (CE). Dig Liver Dis. 2017;49(6):647-650.
23. Stanich PP, Guido J, Kleinman B, Betkerur K, Porter KM, Meyer MM. Video capsule endoscopy completion and total transit times are similar with oral or endoscopic delivery. Endosc Int Open. 2016;4(2):E228-32.
24. Yazici C, Losurdo J, Brown MD, Oosterveen S, Rahimi R, Keshavarzian A, Bozorgnia L, Mutlu E. Inpatient capsule endoscopy leads to frequent incomplete small bowel examinations. World J Gastroenterol. 2012;18(36):5051-7.
25. Ben-Soussan E, Savoye G, Antonietti M, Ramirez S, Lerebours E, Ducrotté P.Factors that affect gastric passage of video capsule. Gastrointest Endosc. 2005;62(5):785-90.
26. Lim YJ, Lee OY, Jeen YT, Lim CY, Cheung DY, Cheon JH, Ye BD, Song HJ, Kim JS, Do JH, Lee KJ, Shim KN, Chang DK, Park CH, Jang BI, Moon JS, Chun HJ, Choi MG, Kim JO; Korean Gut Image Study Group. Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry. Clin Endosc. 2015;48(5):399-404.
27. Triantafyllou K, Kalantzis C, Papadopoulos AA, Apostolopoulos P, Rokkas T, Kalantzis N, Ladas SD. Video-capsule endoscopy gastric and small bowel transit time and completeness of the examination in patients with diabetes mellitus. Dig Liver Dis. 2007;39(6):575-80.
28. Niv E, Pinchasovich H, Yanai H. Impact of demographic and clinical parameters on video capsule transit time. Eur J Gastroenterol Hepatol. 2016;28(10):1161-5.
29. Rondonotti E, Spada C, Adler S, May A, Despott EJ, Koulaouzidis A, Panter S, Domagk D, Fernandez-Urien I, Rahmi G, Riccioni ME, van Hooft JE, Hassan C, Pennazio M. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. Endoscopy. 2018;50(4):423-446.
30. Alsahafi M, Cramer P, Chatur N, Donnellan F. The Effect of Prucalopride on Small Bowel Transit Time in Hospitalized Patients Undergoing Capsule Endoscopy.Can J Gastroenterol Hepatol. 2017;2017:2696947.
31. Stanich PP, Peck J, Murphy C, Porter KM, Meyer MM. Physical activity during video capsule endoscopy correlates with shorter bowel transit time. Endosc Int Open. 2017;5(9):E856-E860.
32. Westerhof J, Weersma RK, Hoedemaker RA, Koornstra JJ. Completion rate of small bowel capsule endoscopy is higher after erythromycin compared to domperidone. BMC Gastroenterol. 2014;14:162
33. Leung WK, Chan FK, Fung SS, Wong MY, Sung JJ. Effect of oral erythromycin on gastric and small bowel transit time of capsule endoscopy. World J Gastroenterol. 2005;11(31):4865-8.
34. Liao Z, Li F, Li ZS. Right lateral position improves complete examination rate of capsule endoscope: a prospective randomized, controlled trial. Endoscopy. 2008;40(6):483-7.
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Macías E, Elosua González A, Juanmartiñena J, Borda Martín A, Elizalde I, Fernández-Urién I, et all. Can we predict an incomplete capsule endoscopy? Results of a multivariate analysis using a logistic regression model. 7320/2020


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Publication history

Received: 07/06/2020

Accepted: 08/09/2021

Online First: 14/09/2021

Published: 07/06/2022

Article revision time: 335 days

Article Online First time: 464 days

Article editing time: 730 days


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