Τίτλος:
Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background & aims: Video capsule endoscopy (VCE) is the first-line diagnostic procedure for investigating obscure gastrointestinal bleeding (OGIB). Different re-bleeding rates following index VCE have been reported among Western and Eastern studies. Methods: We conducted a comprehensive literature search to identify studies examining re-bleeding rates after VCE for OGIB. Meta-analysis assessed the pooled proportion of re-bleeding events after VCE for OGIB according to study's origin (Western vs. Eastern) and according to the length of follow-up (≥24 months vs. <24 months). We also calculated the re-bleeding odds ratios (OR; 95% CI) after positive vs. negative index VCE, overt vs. occult initial presentation of bleeding and after interventional treatment for positive index cases, according to the study's origin. Results: We included 46 (30 Western and 16 Eastern) studies with 5796 patients. Significant heterogeneity was detected among meta-analyzed studies. Overall, the pooled re-bleeding rate was similar between Western (29%; 95% CI: 23–34) and Eastern (21%; 95% CI: 15–27) populations, irrespective of the length of follow-up. The odds of re-bleeding was significantly higher after positive as compared to negative index VCE in Eastern studies (OR: 1.77; 95% CI: 1.07–2.94). Application of specific treatment after positive index VCE was associated with lower re-bleeding odds in both Western (OR: 0.37; 95% CI: 0.16–0.87) and Eastern (OR: 0.39; 95% CI: 0.21–0.72) populations. Conclusions: Patients undergoing VCE for OGIB have similar re-bleeding rates in the East and the West, regardless of the length of follow-up. However, increased re-bleeding odds after positive index VCE is observed in Eastern studies. © 2018 Editrice Gastroenterologica Italiana S.r.l.
Συγγραφείς:
Tziatzios, G.
Gkolfakis, P.
Hassan, C.
Toth, E.
Zullo, A.
Koulaouzidis, A.
Dimitriadis, G.D.
Triantafyllou, K.
Περιοδικό:
Digestive and Liver Disease
Λέξεις-κλειδιά:
capsule endoscopy; clinical evaluation; clinical outcome; diagnostic imaging; diagnostic procedure; follow up; gastrointestinal hemorrhage; human; medical literature; meta analysis; obscure gastrointestinal bleeding; priority journal; retrospective study; Review; risk assessment; sensitivity analysis; systematic review; video capsule endoscopy; videorecording; capsule endoscopy; gastrointestinal hemorrhage; procedures; recurrent disease; statistical bias, Bias; Capsule Endoscopy; Gastrointestinal Hemorrhage; Humans; Recurrence
DOI:
10.1016/j.dld.2017.12.031
