Impact of inpatient status and gender on small-bowel capsule endoscopy findings

BackgroundVideo capsule endoscopy (VCE) is most commonly performed in the outpatient setting to evaluate obscure GI bleeding.ObjectiveTo determine the impact of gender and inpatient status on VCE findings.DesignRetrospective study.SettingTwo tertiary medical centers and a VA medical center.PatientsA total of 167 inpatients and 540 outpatients undergoing 707 VCE examinations for obscure GI bleeding.InterventionsVCE study.Main outcome measurementsPatient age, sex, indication for VCE, gastric and small-bowel transit times, significant VCE findings including detection of blood in the lumen and major lesions outside the small bowel, and presence of comorbid conditions.ResultsSignificant VCE findings were identified more frequently during inpatient VCE examinations (48% vs 37%, P = .009). Endoscopic placement, nongastric passage, and incomplete studies to the cecum were more common for inpatient VCE examinations. Gastric transit time, but not small-bowel transit time, was longer in inpatient VCE studies. Inpatient VCE examinations were more common in male patients (73% vs 61%, P = .004) and patients with overt bleeding (83% vs 46%, P < .05). The overall diagnostic VCE rate was higher for male patients because of a higher prevalence of angiodysplastic lesions and major findings outside the small bowel.LimitationsRetrospective study. Lack of information regarding timing of VCE study, most recent episode of obscure bleeding, and comorbidity data for outpatients.ConclusionThe overall diagnostic yield was higher for inpatient VCE examinations. Male patients were more likely to demonstrate significant findings on both inpatient and outpatient VCE studies because of a higher prevalence of angiodysplastic lesions and findings outside the small bowel.