Abstract:
We aimed to determine the diagnostic yield and outcome of patients receiving antithrombotic drug therapy subjected to small bowel capsule endoscopy (SBCE) for the investigation of small bowel bleeding (SBB). A multicenter retrospective analysis of collected data from all patients undergoing SBCE for the investigation of SBB from March 2003 to June 2023 was performed. The diagnostic yield of SBCE was defined as the detection of positive findings that could explain the cause of the patient\'s bleeding. Rebleeding was defined as evidence of bleeding within 1 year after the index episode. During the study period, 8401 patients underwent SBCE for SBB investigation. Bleeding lesions were detected in 1103/2535 (43.5%) antithrombotic users, compared to 1113/5866 (18.9%) in nonusers (p < 0.00001). Following capsule endoscopy, a therapeutic intervention was possible in 390/2216 (17.5%) patients with a bleeding lesion. Rebleeding occurred in 927 (36.5%) of antithrombotic users (36.5%), compared to 795 (13.5%) of nonusers (13.5%, p < 0.00001). Both the diagnostic yield of SBCE and the rebleeding rates were higher in patients with SBB receiving antithrombotics. Therapeutic intervention was possible in a real-world setting only for a minority of patients with positive findings.
摘要:
我们旨在确定接受抗血栓药物治疗的患者接受小肠胶囊内窥镜检查(SBCE)以调查小肠出血(SBB)的诊断率和结果。对2003年3月至2023年6月接受SBCE调查的所有患者的数据进行了多中心回顾性分析。SBCE的诊断率定义为检测到可以解释患者出血原因的阳性结果。再出血定义为在指数发作后1年内出血的证据。在学习期间,8401名患者接受SBCE进行SBB调查。在1103/2535(43.5%)抗血栓使用者中检测到出血病变,与非使用者的1113/5866(18.9%)相比(p<0.00001)。胶囊内窥镜检查后,390/2216例(17.5%)有出血性病变的患者可以进行治疗性干预.927(36.5%)的抗血栓使用者(36.5%)发生了再出血,与795(13.5%)的非用户(13.5%,p<0.00001)。接受抗血栓治疗的SBB患者的SBCE诊断率和再出血率均较高。在现实世界中,只有少数发现阳性的患者才有可能进行治疗干预。