Su1292 12-HOUR VIDEO CAPSULE ENDOSCOPY IMPROVES SUCCESS RATE OF SMALL BOWEL EVALUATION IN HOSPITALIZED PATIENTS WITH OBSCURE GASTROINTESTINAL BLEED

Video capsule endoscopy (VCE) is used for evaluation of obscure GI bleeding (OGIB) in hospitalized patients. One limitation of VCE is the potential for an incomplete study resulting in an inadequate evaluation of the small bowel and delay in delivery of care. Recently, VCE with an extended recording time of 12 hours was introduced at the same cost of an 8 hour VCE. We sought to evaluate if prolonged recording time improved the success rate of study completion and determine risk factors for incomplete studies. We performed a retrospective chart review at a single tertiary care medical center of hospitalized patients who underwent 8 or 12 hour VCE for evaluation of OGIB between January 2014 and September 2017. We obtained patient age, gender, history of diabetes, inpatient opiate use, history of bowel obstruction, history of abdominal surgery, method of capsule delivery, adequacy of bowel prep after 1 gallon of GoLytely, and indication for VCE for these patients. Out of a total of 191 VCE studies performed, 151 were with 8 hour VCE and 40 were with 12 hour VCE. There was a statistically significant higher completion rate with 12 hour VCE compared to 8 hour VCE (92% versus 78%, p = 0.04, OR = 3.45) (Table 1). Patients who had 12 hour VCE had abdominal surgery and iron deficiency anemia at significantly lower rates than those who had an 8 hour VCE (28% versus 13%, p = 0.03, and 70% versus 39%, p < 0.001, respectively). There were no statistically significant differences in the other patient characteristics (Table 2). Factors that increased risk of an incomplete study included a history of bowel obstruction (p = 0.02), inpatient opiate use (p = 0.05), older age (p = 0.03), and history of abdominal surgery (p < 0.01) in both groups. In the 12 hour VCE group, only inpatient opiate use (p = 0.05) and history of abdominal surgery (p = 0.02) were statistically significant risk factors when compared to the 8 hour VCE group. The method of delivery, either swallowed or endoscopically deployed, did not improve the rate of completion of VCE in either group. In the evaluation of OGIB, use of 12 hour VCE is associated with more frequent successful visualization of the entirety of hospitalized patients' small intestine. There were no unique risk factors for incomplete studies observed in 12 hour VCE. Further studies in patients with abdominal operations may be beneficial. The use of 12 hour VCE can lead to efficient care delivery, and thus should be considered for implementation as standard practice.