CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(06): E688-E693
DOI: 10.1055/a-0593-5915
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Diagnostic yield and predictive factors of findings in small-bowel capsule endoscopy in the setting of iron-deficiency anemia

Carolina Olano
Clinica de Gastroenterología “Prof. Henry Cohen”, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
,
Ximena Pazos
Clinica de Gastroenterología “Prof. Henry Cohen”, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
,
Karla Avendaño
Clinica de Gastroenterología “Prof. Henry Cohen”, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
,
Alfonso Calleri
Clinica de Gastroenterología “Prof. Henry Cohen”, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
,
Carlos Ketzoian
Clinica de Gastroenterología “Prof. Henry Cohen”, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
› Author Affiliations
Further Information

Publication History

submitted 27 September 2017

accepted after revision 20 February 2018

Publication Date:
25 May 2018 (online)

Abstract

Introduction Despite the widespread use of small-bowel capsule endoscopy (CE), there is still limited data on its utility and effectiveness for the diagnosis and management of patients with iron-deficiency anemia (IDA).

Aim To assess the diagnostic yield of CE and the factors predicting positive findings in patients with IDA.

Methods Patients with unexplained IDA and negative upper and lower endoscopy were included. A positive diagnostic yield was considered when CE diagnosed one or more lesions that could explain the IDA. Sex, age, NSAID consumption, blood transfusion requirement, and ferritin and hemoglobin levels were recorded.

Results In total, 120 CE were included (mean age 58.5 years; F/M 82:38). Mean hemoglobin levels were 9 g/dL and mean ferritin levels were 15.7 ng/mL. Positive findings were present in 50 % of patients. The most frequent was angiodysplasia (45 %). Despite several baseline variables being significantly associated with positive findings, using a logistic regression model, it was verified that male sex (OR 3.93; 95 %CI 1.57 – 9.86), age (OR 1.03; 95 %CI 1.00 – 1.06), and hemoglobin levels (OR 0.73; 95 %CI 0.57 – 0.94) were the variables having an independent effect on the probability of obtaining positive findings. Age older than 50 years (OR 14.05; 95 %CI 1.69 – 116.23) and male sex (OR 3.63; 95 %CI 1.29 – 10.17) were the variables which increased the risk of diagnosing angiodysplasia.

Conclusions CE is a useful technique in patients with IDA. To improve its yield, it is necessary to select patients carefully. Male sex, older age, and low hemoglobin levels were associated with a risk of positive finding in this group of patients. The risk of diagnosing angiodysplasia increased with male sex and older age.