Development and validation of a new scoring system to determine the necessity of small-bowel endoscopy in obscure gastrointestinal bleeding. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Uchida, Genta; Nakamura, Masanao; Watanabe, Osamu; Yamamura, Takeshi; Ishikawa, Takuya; Furukawa, Kazuhiro; Funasaka, Kohei; Ohno, Eizaburo; Kawashima, Hiroki; Miyahara, Ryoji; Goto, Hidemi; Hirooka, Yoshiki
• Is Part Of: Digestive and liver disease. Volume 49:Issue 11(2017)
• Page Start: 1218
• Page End: 1224
• Publication Date: 2017-11
• Subjects: Capsule endoscopy -- Predictive factor -- Score; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2017.08.036
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Small bowel capsule endoscopy (SBCE) is the recommended first-line procedure for obscure gastrointestinal bleeding (OGIB). However, a method for predicting the necessity of subsequent double-balloon endoscopy (DBE) has not been established. Aims: We aimed to develop a new scoring system that predicts the necessity of DBE in OGIB. Methods: A retrospective study was performed in 330 patients who underwent SBCE for OGIB at Nagoya University Hospital. The enrolled patients were randomly assigned to either a development or a validation dataset. The former was used to construct a prediction scoring system to assess the necessity of DBE using independent predictors selected by logistic regression. The diagnostic yield of the prediction model was assessed using the validation dataset. Results: Multivariate logistic regression analysis of the development dataset identified OGIB type, blood transfusion, and SBCE findings as independent predictors of the necessity of DBE. A prediction score gave an area under the receiver operating characteristics curve of 0.77. The sensitivity, specificity, positive predictive value, and negative predictive value at a cutoff ≥2.5 points were 72.5%, 74.6%, 72.6%, and 74.5%, respectively. Conclusion: Our scoring system may aid clinicians in deciding when to recommend DBE for patients with OGIB.